Provider Demographics
NPI:1417396151
Name:MULTICULTURAL DEVELOPMENT SERVICES, LLC
Entity type:Organization
Organization Name:MULTICULTURAL DEVELOPMENT SERVICES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:DAMARIS
Authorized Official - Middle Name:
Authorized Official - Last Name:BAEZ
Authorized Official - Suffix:
Authorized Official - Credentials:BCABA
Authorized Official - Phone:754-600-9265
Mailing Address - Street 1:PO BOX 26055
Mailing Address - Street 2:
Mailing Address - City:TAMARAC
Mailing Address - State:FL
Mailing Address - Zip Code:33320-6055
Mailing Address - Country:US
Mailing Address - Phone:754-600-9265
Mailing Address - Fax:954-343-3644
Practice Address - Street 1:4987 N UNIVERSITY DR
Practice Address - Street 2:SUITE 14-A
Practice Address - City:LAUDERHILL
Practice Address - State:FL
Practice Address - Zip Code:33351-4506
Practice Address - Country:US
Practice Address - Phone:954-353-9777
Practice Address - Fax:954-343-3644
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-06-16
Last Update Date:2013-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Single Specialty