Organization
CHANGING LIVES BEHAVIORAL SUPPORT CORP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DAYNELL SANTANA ECHEVARRIA (PRESIDENT)
(346) 558-4018
Entity
Organization
Contact information
Practice address
175 FONTAINEBLEAU BLVD STE 2J1A, MIAMI, FL 33172-7017
(305) 590-1085
Mailing address
175 FONTAINEBLEAU BLVD STE 2J1A, MIAMI, FL 33172-7017
(305) 590-1085
(305) 590-1085
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
123329800
—
FL
Enumeration date
07/18/2024
Last updated
09/05/2025
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