Provider Demographics
NPI:1154156917
Name:SUPPORTIVE ABA THERAPY FL LLC
Entity type:Organization
Organization Name:SUPPORTIVE ABA THERAPY FL LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:FOUNDER
Authorized Official - Prefix:
Authorized Official - First Name:YOSEF
Authorized Official - Middle Name:
Authorized Official - Last Name:TOLEDANO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:917-831-9691
Mailing Address - Street 1:667 RODRIGUES LN
Mailing Address - Street 2:
Mailing Address - City:JACKSON
Mailing Address - State:NJ
Mailing Address - Zip Code:08527-4818
Mailing Address - Country:US
Mailing Address - Phone:917-831-9691
Mailing Address - Fax:
Practice Address - Street 1:1810 N 52ND AVE
Practice Address - Street 2:
Practice Address - City:HOLLYWOOD
Practice Address - State:FL
Practice Address - Zip Code:33021-3912
Practice Address - Country:US
Practice Address - Phone:917-831-9691
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-09-03
Last Update Date:2024-09-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Single Specialty