Healthcare Provider Details

I. General information

NPI: 1366215162
Provider Name (Legal Business Name): APEX ABA THERAPY GA LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/02/2023
Last Update Date: 06/27/2024
Certification Date: 06/20/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3372 PEACHTREE RD NE STE 115
ATLANTA GA
30326-1963
US

IV. Provider business mailing address

1500 AVENUE OF THE STATES STE 400
LAKEWOOD NJ
08701-4792
US

V. Phone/Fax

Practice location:
  • Phone: 732-534-3101
  • Fax: 732-534-3119
Mailing address:
  • Phone: 732-534-3101
  • 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: SHIMON EHRMAN
Title or Position: DIRECTOR
Credential:
Phone: 732-534-3101