Healthcare Provider Details

I. General information

NPI: 1346135779
Provider Name (Legal Business Name): ABA GOLDEN STEPS AZ LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/09/2025
Last Update Date: 06/09/2025
Certification Date: 06/09/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1148 W BASELINE RD
MESA AZ
85210-5971
US

IV. Provider business mailing address

560 SYLVAN AVE STE 2048
ENGLEWOOD CLIFFS NJ
07632-3165
US

V. Phone/Fax

Practice location:
  • Phone: 602-325-9940
  • Fax:
Mailing address:
  • Phone: 678-894-1116
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number
License Number State

VIII. Authorized Official

Name: REBECCA RROSS
Title or Position: CREDENTIALING MANAGER
Credential:
Phone: 678-894-1116