Provider Demographics
NPI:1912792862
Name:CONNECTION - TRANSDISCIPLINARY THERAPEUTIC SUPPORT CENTER, LLC
Entity type:Organization
Organization Name:CONNECTION - TRANSDISCIPLINARY THERAPEUTIC SUPPORT CENTER, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER / OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:ANDRE
Authorized Official - Middle Name:DE PAIVA COELHO
Authorized Official - Last Name:SOPHIA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:954-253-6455
Mailing Address - Street 1:1191 E NEWPORT CENTER DR STE 103
Mailing Address - Street 2:
Mailing Address - City:DEERFIELD BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33442-7736
Mailing Address - Country:US
Mailing Address - Phone:954-644-0682
Mailing Address - Fax:754-333-4768
Practice Address - Street 1:1191 E NEWPORT CENTER DR STE 103
Practice Address - Street 2:
Practice Address - City:DEERFIELD BEACH
Practice Address - State:FL
Practice Address - Zip Code:33442-7736
Practice Address - Country:US
Practice Address - Phone:954-644-0682
Practice Address - Fax:754-333-4768
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-04-11
Last Update Date:2025-04-11
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
No224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy AssistantGroup - Multi-Specialty
No225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGroup - Multi-Specialty
No225XM0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistMental HealthGroup - Multi-Specialty
No235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Multi-Specialty