Organization
ABA CONQUEST, LLC
Active
Organization
ABA CONQUEST, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JOSEPH MCGAHAN (MANAGER)
(772) 349-1186
Entity
Organization
Contact information
Practice address
1365 SW VIZCAYA CIR, PALM CITY, FL 34990-1962
(772) 349-1186
(772) 324-8766
Mailing address
1365 SW VIZCAYA CIR, PALM CITY, FL 34990-1962
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
1-14-16478
FL
252Y00000X
Early Intervention Provider Agency
Primary
1-14-16478
FL
Other
Enumeration date
07/16/2015
Last updated
04/01/2016
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