Healthcare Provider Details

I. General information

NPI: 1194682088
Provider Name (Legal Business Name): GENESIS ABA THERAPY LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/05/2026
Last Update Date: 09/18/2026
Certification Date: 09/18/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

309 COURT AVE STE 820
DES MOINES IA
50309-2282
US

IV. Provider business mailing address

309 COURT AVE STE 820
DES MOINES IA
50309-2282
US

V. Phone/Fax

Practice location:
  • Phone: 319-383-2701
  • Fax:
Mailing address:
  • Phone: 319-383-2701
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number
License Number StateNULL

VIII. Authorized Official

Name: MR. NEHEMIAH SAHR KOROMA
Title or Position: OWNER/BEHAVIOR ANALYST
Credential: BCBA
Phone: 319-383-2701