Provider Demographics
NPI:1609696111
Name:SPRINGBOARD ABA LLC
Entity type:Organization
Organization Name:SPRINGBOARD ABA LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:COO
Authorized Official - Prefix:MR
Authorized Official - First Name:MARK
Authorized Official - Middle Name:
Authorized Official - Last Name:FEUER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:845-633-4539
Mailing Address - Street 1:300 N MAIN ST STE 303
Mailing Address - Street 2:
Mailing Address - City:SPRING VALLEY
Mailing Address - State:NY
Mailing Address - Zip Code:10977-3774
Mailing Address - Country:US
Mailing Address - Phone:845-633-4539
Mailing Address - Fax:
Practice Address - Street 1:10801 PAUL EELLS DR
Practice Address - Street 2:
Practice Address - City:NORTH LITTLE ROCK
Practice Address - State:AR
Practice Address - Zip Code:72113-7608
Practice Address - Country:US
Practice Address - Phone:845-633-4539
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-10-10
Last Update Date:2024-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Single Specialty