Healthcare Provider Details
I. General information
NPI: 1992405021
Provider Name (Legal Business Name): LETS PLAY ABA LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 03/07/2023
Last Update Date: 02/04/2025
Certification Date: 02/04/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
906 HOBSON AVE
HOT SPRINGS AR
71913-3403
US
IV. Provider business mailing address
140 RIVERS DR
HOT SPRINGS AR
71913-7015
US
V. Phone/Fax
- Phone: 501-566-4796
- Fax: 501-501-2117
- Phone: 501-596-1711
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 106S00000X |
| Taxonomy | Behavior Technician |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 103K00000X |
| Taxonomy | Behavior Analyst |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
DESIRAE
BENCHOFF
Title or Position: OWNER
Credential:
Phone: 501-566-4796