| Entity Name: | MCC ABA THERAPY INC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Profit Corporation |
| Status: | Active |
| Date Filed: | 01 Dec 2022 (2 years ago) |
| Document Number: | P22000089382 |
| FEI/EIN Number | 92-1260169 |
| Address: | 13550 SW 88TH ST, 270A, MIAMI, FL 33186 |
| Mail Address: | 13550 SW 88TH ST, 270A, MIAMI, FL 33186 |
| ZIP code: | 33186 |
| County: | Miami-Dade |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1508577974 | 2022-12-07 | 2022-12-08 | 13550 SW 88TH ST STE 270A, MIAMI, FL, 331861513, US | 13550 SW 88TH ST STE 270A, MIAMI, FL, 331861513, US | |||||||||||||||||||||
|
|||||||||||||||||||||||||
| Phone | +1 786-398-0187 |
| Fax | 3054567064 |
Authorized person
| Name | MARLENE CARRION CRUZ |
| Role | C.E.O |
| Phone | 7863980187 |
Taxonomy
| Taxonomy Code | 103K00000X - Behavior Analyst |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 021946900 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| CARRION CRUZ, MARLENE | Agent | 15701 SW 139TH CT, MIAMI, FL 33177 |
| Name | Role | Address |
|---|---|---|
| CARRION CRUZ, MARLENE | President | 15701 SW 139TH CT, MIAMI, FL 33177 |
| Name | Role | Address |
|---|---|---|
| FRANCHI ALFARO, LUIS | Vice President | 15720 SW 139TH AVE, MIAMI, FL 33177 |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-02-20 |
| ANNUAL REPORT | 2023-02-28 |
| Domestic Profit | 2022-12-01 |
Date of last update: 11 Jan 2025
Sources: Florida Department of State
