Organization
ABA TREEHOUSE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
WILLIE WALLACE (OWNER)
(386) 383-4562
Entity
Organization
Contact information
Practice address
1616 CONCIERGE BLVD FL 1, DAYTONA BEACH, FL 32117-7158
(386) 383-4562
(386) 401-2385
Mailing address
1616 CONCIERGE BLVD FL 1, DAYTONA BEACH, FL 32117-7158
(386) 383-4562
(386) 401-2385
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
—
—
Other
Enumeration date
02/17/2026
Last updated
02/17/2026
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