Organization
CREATING A DIFFERENCE LLC
Active
Organization
CREATING A DIFFERENCE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DIANA BENCID MS, BCBA (SOLE MEMBER)
(786) 301-7622
Entity
Organization
Contact information
Practice address
800 CYPRESS BLVD APT 204, POMPANO BEACH, FL 33069-4078
(786) 301-7622
Mailing address
43 S POWERLINE RD # 248, POMPANO BEACH, FL 33069-3001
(786) 301-7622
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
1-17-27747
FL
251S00000X
Community/Behavioral Health Agency
Primary
—
—
261QD1600X
Developmental Disabilities Clinic/Center
—
—
261QM0855X
Adolescent and Children Mental Health Clinic/Center
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
019640300
—
FL
01
—
1-17-27747
CERTIFICATION NUMBER FOR BCBA
FL
Enumeration date
12/26/2017
Last updated
12/27/2017
Update your record
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