Provider Demographics
NPI:1114378445
Name:MAKING STRIDES ABA THERAPY LLC
Entity type:Organization
Organization Name:MAKING STRIDES ABA THERAPY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:KIARA
Authorized Official - Middle Name:
Authorized Official - Last Name:SANTIAGO
Authorized Official - Suffix:
Authorized Official - Credentials:BCBA
Authorized Official - Phone:516-547-5024
Mailing Address - Street 1:4651 BABCOCK ST NE
Mailing Address - Street 2:STE 18
Mailing Address - City:PALM BAY
Mailing Address - State:FL
Mailing Address - Zip Code:32905-2844
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:4651 BABCOCK ST NE
Practice Address - Street 2:STE 18
Practice Address - City:PALM BAY
Practice Address - State:FL
Practice Address - Zip Code:32905-2844
Practice Address - Country:US
Practice Address - Phone:321-338-3936
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-06-28
Last Update Date:2016-06-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Single Specialty