MEDICARE: CORE SKILLS 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
1	103K00000X	Behavior Analyst

General Provider Information

NPI Number	:	1518805225
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CORE SKILLS ABA LLC

Provider Business Mailing Address
First Line	:	29712 FULSHEAR LAKE TRCE
Second Line	:
City	:	RICHMOND
State	:	TX
Zip	:	77406-3316
Country	:	US
Telephone Number	:	832-628-7570
Fax Number	:

Provider Business Practice Location Address
First Line	:	29712 FULSHEAR LAKE TRCE
Second Line	:
City	:	RICHMOND
State	:	TX
Zip	:	77406-3316
Country	:	US
Telephone Number	:	832-628-7570
Fax Number	:

Authorized Official
Title or Position	:	MANAGING MEMBER
Name	:	ADAEZE FREGENE
Credential	:
Telephone Number	:	832-628-7570

Provider Enumeration Date	:	03/23/2026
Last Update Date	:	03/23/2026

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