Organization · NPI-2

Applied Behavior Autism Center LLC

Behavior Analyst · Moreno Valley, CA

NPI number1821623018

StatusActive

Last updated in NPPESApr 17, 2020

Details

NPI: 1821623018
Entity type: Organization (NPI-2)
Legal business name: Applied Behavior Autism Center LLC
Organization subpart: No
Enumeration date: Mar 8, 2020
Certification date: Apr 17, 2020
Last updated: Apr 17, 2020

Taxonomy and licenses

Taxonomy code	Description	License	State	Primary
103K00000X	Behavior Analyst	–	–	Yes
251S00000X	Community/Behavioral Health	–	–
261QM0855X	Clinic/Center, Adolescent and Children Mental Health	–	–

Practice location

24081 Sandy Glade Ave
Moreno Valley, CA 92557-5529

Phone 916-869-2416 · Fax 512-572-8647

Mailing address

5838 Toscana Trce
Round Rock, TX 78665-4402

Phone 916-869-2416

Other practice locations

5838 Toscana Trce
Round Rock, TX 78665-4402

Phone 916-869-2416

Authorized official

Shamica Morton
Owner
9168692416

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