MEDICARE: GOLD STANDARD ABA DE 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
1	103K00000X	Behavior Analyst

General Provider Information

NPI Number	:	1376475319
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	GOLD STANDARD ABA DE LLC

Provider Business Mailing Address
First Line	:	1401 PENNSYLVANIA AVE STE 105
Second Line	:
City	:	WILMINGTON
State	:	DE
Zip	:	19806-4125
Country	:	US
Telephone Number	:	718-427-9168
Fax Number	:	646-693-3193

Provider Business Practice Location Address
First Line	:	1401 PENNSYLVANIA AVE STE 105
Second Line	:
City	:	WILMINGTON
State	:	DE
Zip	:	19806-4125
Country	:	US
Telephone Number	:	718-427-9168
Fax Number	:	646-693-3193

Authorized Official
Title or Position	:	OWNER
Name	:	STEVEN HAIM
Credential	:
Telephone Number	:	718-427-9168

Provider Enumeration Date	:	06/02/2026
Last Update Date	:	06/02/2026

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