| Vital Skills Center Llc | |
|
4117 N Pine Island Rd Sunrise FL 33351-6005 | |
| (954) 652-8613 | |
| Not Available |
| Full Name | Vital Skills Center Llc |
|---|---|
| Speciality | Behavior Analyst |
| Location | 4117 N Pine Island Rd, Sunrise, Florida |
| Authorized Official Name and Position | Ann Marie Wanliss (DIRECTOR) |
| Authorized Official Contact | 9546528613 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Vital Skills Center Llc 9376 Nw 54th St Sunrise FL 33351-7788 Ph: (954) 652-8613 | Vital Skills Center Llc 4117 N Pine Island Rd Sunrise FL 33351-6005 Ph: (954) 652-8613 |
| NPI Number | 1912467788 |
|---|---|
| Provider Enumeration Date | 03/20/2019 |
| Last Update Date | 02/10/2023 |
| Certification Date | 02/10/2023 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1912467788 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103K00000X | Behavior Analyst | (* (Not Available)) | Primary |
| 252Y00000X | Early Intervention Provider Agency | (* (Not Available)) | Secondary |
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