Organization
COUNTRY CLUB ABA SERVICES LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
VICTOR MANUEL ALBERTO MUNOZ (MANAGER)
(786) 307-9711
Entity
Organization
Contact information
Practice address
7838 NW 178TH ST, HIALEAH, FL 33015-3649
(786) 307-9711
Mailing address
6820 N AUGUSTA DR, HIALEAH, FL 33015-2118
(786) 307-9711
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
—
—
Other
Enumeration date
07/11/2023
Last updated
07/11/2023
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