Provider Demographics
NPI:1174330484
Name:SPARK ABA LLC
Entity type:Organization
Organization Name:SPARK ABA LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CO-OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:YOSEF
Authorized Official - Middle Name:ABDEL
Authorized Official - Last Name:ABUSHAABAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:832-776-9447
Mailing Address - Street 1:5501 CABRERA DR STE 205
Mailing Address - Street 2:
Mailing Address - City:SUGAR LAND
Mailing Address - State:TX
Mailing Address - Zip Code:77479-7261
Mailing Address - Country:US
Mailing Address - Phone:832-532-2864
Mailing Address - Fax:
Practice Address - Street 1:5501 CABRERA DR STE 205
Practice Address - Street 2:
Practice Address - City:SUGAR LAND
Practice Address - State:TX
Practice Address - Zip Code:77479-7261
Practice Address - Country:US
Practice Address - Phone:832-532-2864
Practice Address - Fax:713-583-8456
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-12-11
Last Update Date:2025-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Single Specialty