Provider Demographics
NPI:1447841515
Name:SAGARIAN ENTERPRISES, LLC
Entity type:Organization
Organization Name:SAGARIAN ENTERPRISES, LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:BCBA
Authorized Official - Prefix:
Authorized Official - First Name:AMANDA
Authorized Official - Middle Name:TERESE
Authorized Official - Last Name:SAGARIAN
Authorized Official - Suffix:
Authorized Official - Credentials:BCBA
Authorized Official - Phone:727-643-7695
Mailing Address - Street 1:12191 W LINEBAUGH AVE, #668
Mailing Address - Street 2:
Mailing Address - City:WESTCHASE
Mailing Address - State:FL
Mailing Address - Zip Code:33626
Mailing Address - Country:US
Mailing Address - Phone:727-643-7695
Mailing Address - Fax:
Practice Address - Street 1:1022 MAIN ST STE J
Practice Address - Street 2:
Practice Address - City:DUNEDIN
Practice Address - State:FL
Practice Address - Zip Code:34698-5237
Practice Address - Country:US
Practice Address - Phone:727-643-7695
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-02-01
Last Update Date:2021-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL018952200Medicaid