| Stanback Enterprises Llc | |
|
5561 North Winston Park Boulevard Apartment 203 Coconut Creek FL 33073 | |
| (954) 504-6932 | |
| Not Available |
| Full Name | Stanback Enterprises Llc |
|---|---|
| Speciality | Behavior Analyst |
| Location | 5561 North Winston Park Boulevard, Coconut Creek, Florida |
| Authorized Official Name and Position | Nikeda J Stanback (OWNER) |
| Authorized Official Contact | 9545046932 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Stanback Enterprises Llc 5379 Lyons Rd # 813 Coconut Creek FL 33073-2810 Ph: (954) 504-6932 | Stanback Enterprises Llc 5561 North Winston Park Boulevard Apartment 203 Coconut Creek FL 33073 Ph: (954) 504-6932 |
| NPI Number | 1700426210 |
|---|---|
| Provider Enumeration Date | 01/13/2020 |
| Last Update Date | 01/13/2020 |
| Certification Date | 01/13/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1700426210 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103K00000X | Behavior Analyst | (* (Not Available)) | Primary |
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