Healthcare Provider Details
I. General information
NPI: 1194649731
Provider Name (Legal Business Name): STARLIGHT ABA AL LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 08/06/2026
Last Update Date: 08/06/2026
Certification Date: 08/06/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
6 OFFICE PARK CIR STE 105
MOUNTAIN BRK AL
35223-2540
US
IV. Provider business mailing address
6 OFFICE PARK CIR STE 105
MOUNTAIN BRK AL
35223-2540
US
V. Phone/Fax
- Phone: 347-454-6140
- Fax:
- Phone: 347-454-6140
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 103K00000X |
| Taxonomy | Behavior Analyst |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
RAIZEL
LEBOVITS
Title or Position: DIRECTOR
Credential:
Phone: 347-454-6140