Provider Demographics
NPI:1285388397
Name:LILLY PADS ABA THERAPY CORP
Entity type:Organization
Organization Name:LILLY PADS ABA THERAPY CORP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:CLAUDIA
Authorized Official - Middle Name:B
Authorized Official - Last Name:ZINNER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:561-926-2537
Mailing Address - Street 1:4800 N FEDERAL HWY STE 101D
Mailing Address - Street 2:
Mailing Address - City:BOCA RATON
Mailing Address - State:FL
Mailing Address - Zip Code:33431-5178
Mailing Address - Country:US
Mailing Address - Phone:561-926-2537
Mailing Address - Fax:
Practice Address - Street 1:4800 N FEDERAL HWY STE 101D
Practice Address - Street 2:
Practice Address - City:BOCA RATON
Practice Address - State:FL
Practice Address - Zip Code:33431-5178
Practice Address - Country:US
Practice Address - Phone:561-926-2537
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-02-08
Last Update Date:2022-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL017837000Medicaid