Organization
J. CUSAAC, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JACQUELINE A CUSAAC (BCBA)
(561) 445-9220
Entity
Organization
Contact information
Practice address
11085 HARBOUR SPRINGS CIR, BOCA RATON, FL 33428-1244
(561) 445-9220
Mailing address
11085 HARBOUR SPRINGS CIR, BOCA RATON, FL 33428
(561) 445-9220
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
018571500
—
FL
01
—
12759738
CIGNA
FL
Enumeration date
02/16/2017
Last updated
02/16/2017
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