Healthcare Provider Details

I. General information

NPI: 1043889934
Provider Name (Legal Business Name): HEARTLINKS ABA GA LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/23/2021
Last Update Date: 06/23/2021
Certification Date: 06/23/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

100 BULL ST STE 200
SAVANNAH GA
31401-3378
US

IV. Provider business mailing address

2146 59TH ST
BROOKLYN NY
11204-2502
US

V. Phone/Fax

Practice location:
  • Phone: 718-781-2553
  • Fax:
Mailing address:
  • Phone: 718-781-2553
  • 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 Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State

VIII. Authorized Official

Name: ANNA GIPS
Title or Position: DIRECTOR
Credential: BCBA LBA
Phone: 718-781-2553