Provider Demographics
NPI:1386332823
Name:MY TIME 2 LAUNCH, LLC
Entity type:Organization
Organization Name:MY TIME 2 LAUNCH, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF CLINICAL OFFICER
Authorized Official - Prefix:MS
Authorized Official - First Name:RHONDA
Authorized Official - Middle Name:J
Authorized Official - Last Name:GREENHAW
Authorized Official - Suffix:
Authorized Official - Credentials:MA, BCBA 1-11-8196
Authorized Official - Phone:262-707-3257
Mailing Address - Street 1:3832 SW 33RD CT
Mailing Address - Street 2:
Mailing Address - City:WEST PARK
Mailing Address - State:FL
Mailing Address - Zip Code:33023-5631
Mailing Address - Country:US
Mailing Address - Phone:262-707-3257
Mailing Address - Fax:954-838-5358
Practice Address - Street 1:3832 SW 33RD CT
Practice Address - Street 2:
Practice Address - City:WEST PARK
Practice Address - State:FL
Practice Address - Zip Code:33023-5631
Practice Address - Country:US
Practice Address - Phone:262-707-3257
Practice Address - Fax:954-838-5358
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-04-24
Last Update Date:2023-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Multi-Specialty
No106E00000XBehavioral Health & Social Service ProvidersAssistant Behavior AnalystGroup - Multi-Specialty
No106S00000XBehavioral Health & Social Service ProvidersBehavior TechnicianGroup - Multi-Specialty