The Engage ABA Resource and Learning Center

Primary specialty

Community/Behavioral Health AgencyTaxonomy code 251S00000X

License

0-15-6527 Issued in FL

Legal business name

THE ENGAGE ABA RESOURCE AND LEARNING CENTER

Practice address

13506 Summerport Village Pkwy # 207
Windermere, FL 34786-7366

Phone

(407) 780-0177

NPI assigned

Sep 23, 2015

Last updated

Sep 23, 2015By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Jazzmyn Iglesia, MS

Title

Bcaba

Phone

(407) 780-0177

Specialties & licenses 1

Addresses

Other identifiers 1

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1442966400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1442966400000",
    "number": "1366811085",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13506 SUMMERPORT VILLAGE PKWY # 207",
            "city": "WINDERMERE",
            "state": "FL",
            "postal_code": "347867366",
            "telephone_number": "407-780-0177"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13506 SUMMERPORT VILLAGE PKWY # 207",
            "city": "WINDERMERE",
            "state": "FL",
            "postal_code": "347867366",
            "telephone_number": "407-780-0177"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THE ENGAGE ABA RESOURCE AND LEARNING CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-09-23",
        "last_updated": "2015-09-23",
        "status": "A",
        "authorized_official_last_name": "IGLESIA",
        "authorized_official_first_name": "JAZZMYN",
        "authorized_official_title_or_position": "BCABA",
        "authorized_official_telephone_number": "407-780-0177",
        "authorized_official_credential": "MS"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "FL",
            "license": "0-15-6527",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "601834",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Andrea Ethel Thayer, MSN, APRN
• Heather Thayer, PT, DPT
• Three Twelve LLC
• Ryley Tillery, APRN, FNP-C
• Karen Titzer
• Kaisha Judit Toledo, MS
• Sabrina Teresa Tomka, LMHC, NCC

• Community/Behavioral Health Agency in Windermere, FL
• Providers in Windermere, FL by specialty
• Community/Behavioral Health Agency in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 23, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.