Organization
AWANA BEHAVIORAL COMPANY INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ROBERT JAMES KIDD DPT (PRESIDENT)
(305) 439-0263
Entity
Organization
Contact information
Practice address
525 NW 27TH AVE, MIAMI, FL 33125-3043
(305) 439-0263
(786) 288-3617
Mailing address
525 NW 27TH AVE, MIAMI, FL 33125-3043
(305) 439-0263
(786) 288-3617
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
002500900
—
FL
Enumeration date
08/03/2022
Last updated
08/03/2022
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