Active NPI
All Stars ABA LLC
- Community/Behavioral Health Agency
- West Palm Beach, FL
National Provider Identifier
1487323812
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Community/Behavioral Health Agency
- Legal business name
- ALL STARS ABA LLC
- Practice address
- 7750 Okeechobee Blvd Ste 4-418
West Palm Beach, FL 33411-2104 - Phone
- (845) 507-2752
- NPI assigned
- Sep 9, 2021
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Jacob Mytelka
- Title
- Partner
- Phone
- (561) 621-0070
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Community/Behavioral Health Agency | 251S00000X | Primary |
Addresses
Primary practice location
7750 Okeechobee Blvd Ste 4-418
West Palm Beach, FL 33411-2104
Mailing address
3 E Evergreen Rd
New City, NY 10956-5101
Phone (845) 634-1463
National Provider Directory
National Provider Directory- Tax ID family
- All Stars ABA LLC
Other organizations with this tax ID 1
Organizations that report the same tax identification number in the National Provider Directory.
-
- Community/Behavioral Health Agency
- Atlanta, GA
- NPI 1275125544
Locations
7750 Okeechobee Blvd
Ste 4418
West Palm Beach, FL 33411
Phone (845) 507-2752
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1631145600000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1631145600000",
"number": "1487323812",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3 E EVERGREEN RD",
"city": "NEW CITY",
"state": "NY",
"postal_code": "109565101",
"telephone_number": "845-634-1463"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "7750 OKEECHOBEE BLVD STE 4-418",
"city": "WEST PALM BEACH",
"state": "FL",
"postal_code": "334112104",
"telephone_number": "845-507-2752"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "ALL STARS ABA LLC",
"organizational_subpart": "NO",
"enumeration_date": "2021-09-09",
"last_updated": "2021-09-09",
"certification_date": "2021-09-09",
"status": "A",
"authorized_official_last_name": "MYTELKA",
"authorized_official_first_name": "JACOB",
"authorized_official_title_or_position": "PARTNER",
"authorized_official_telephone_number": "561-621-0070"
},
"taxonomies": [
{
"code": "251S00000X",
"taxonomy_group": "",
"desc": "Community/Behavioral Health",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
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Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 9, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.