Provider Demographics
NPI:1538837372
Name:EMANUEL ABA SERVICES LLC
Entity type:Organization
Organization Name:EMANUEL ABA SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:ANGELA
Authorized Official - Middle Name:M
Authorized Official - Last Name:DONIS
Authorized Official - Suffix:
Authorized Official - Credentials:AO
Authorized Official - Phone:786-828-4363
Mailing Address - Street 1:14961 SW 283RD ST APT 206
Mailing Address - Street 2:
Mailing Address - City:HOMESTEAD
Mailing Address - State:FL
Mailing Address - Zip Code:33033-1590
Mailing Address - Country:US
Mailing Address - Phone:786-828-4363
Mailing Address - Fax:
Practice Address - Street 1:14961 SW 283RD ST APT 206
Practice Address - Street 2:
Practice Address - City:HOMESTEAD
Practice Address - State:FL
Practice Address - Zip Code:33033-1590
Practice Address - Country:US
Practice Address - Phone:786-828-4363
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-09-04
Last Update Date:2021-09-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Multi-Specialty