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NPI Code Detail

MEDICARE: SUCCEED ABA LLC

MEDICARE: SUCCEED ABA LLC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1103K00000XBehavior Analyst

General Provider Information

NPI Number : 1033887807
Entity Type Code : Organization
Provider Name (Legal Business Name) : SUCCEED ABA LLC
Provider Business Mailing Address
First Line : 2 N CENTRAL AVE STE 1800
Second Line :
City : PHOENIX
State : AZ
Zip : 85004-2139
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 2 N CENTRAL AVE STE 1800
Second Line :
City : PHOENIX
State : AZ
Zip : 85004-2139
Country : US
Telephone Number : 463-777-8323
Fax Number :
Authorized Official
Title or Position : CEO
Name : MR. ABRAHAM FRIED
Credential :
Telephone Number : 463-777-8323
Provider Enumeration Date : 09/05/2021
Last Update Date : 09/05/2021

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