Provider Demographics
NPI:1710718820
Name:CLEAR CARE ABA THERAPY CORP
Entity type:Organization
Organization Name:CLEAR CARE ABA THERAPY CORP
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:JOSUE
Authorized Official - Middle Name:
Authorized Official - Last Name:MINAYA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:347-737-2130
Mailing Address - Street 1:1834 PHELAN PL APT 3I
Mailing Address - Street 2:
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10453-5143
Mailing Address - Country:US
Mailing Address - Phone:347-737-2130
Mailing Address - Fax:
Practice Address - Street 1:1834 PHELAN PL APT 3I
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10453-5143
Practice Address - Country:US
Practice Address - Phone:347-737-2130
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-08-10
Last Update Date:2024-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior TechnicianGroup - Multi-Specialty
No103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Multi-Specialty
No225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy AssistantGroup - Multi-Specialty
No225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGroup - Multi-Specialty
No235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Multi-Specialty