Provider Demographics
NPI:1255924916
Name:SYNTHESIS ABA LLC
Entity type:Organization
Organization Name:SYNTHESIS ABA LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO, BCBA
Authorized Official - Prefix:MR
Authorized Official - First Name:MUHAMMED
Authorized Official - Middle Name:S
Authorized Official - Last Name:CONTEH
Authorized Official - Suffix:
Authorized Official - Credentials:MED, BCBA, LBA
Authorized Official - Phone:812-320-8303
Mailing Address - Street 1:KASTEN INDUSTRIAL PARK, SUIT 110
Mailing Address - Street 2:
Mailing Address - City:PORTAGE
Mailing Address - State:MI
Mailing Address - Zip Code:49002
Mailing Address - Country:US
Mailing Address - Phone:812-320-8303
Mailing Address - Fax:
Practice Address - Street 1:KASTEN INDUSTRIAL PARK, SUIT 110
Practice Address - Street 2:
Practice Address - City:PORTAGE
Practice Address - State:MI
Practice Address - Zip Code:49002
Practice Address - Country:US
Practice Address - Phone:812-320-8303
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-02-13
Last Update Date:2021-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Single Specialty
No251S00000XAgenciesCommunity/Behavioral HealthGroup - Single Specialty