Healthcare Provider Details
I. General information
NPI: 1790661213
Provider Name (Legal Business Name): GREAT DAY ABA LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 08/12/2025
Last Update Date: 08/12/2025
Certification Date: 08/12/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
3906 11TH PL
DES MOINES IA
50313-3231
US
IV. Provider business mailing address
3906 11TH PL
DES MOINES IA
50313-3231
US
V. Phone/Fax
- Phone: 801-597-3294
- Fax:
- Phone:
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 103K00000X |
| Taxonomy | Behavior Analyst |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 106S00000X |
| Taxonomy | Behavior Technician |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
NICHOLAS
KLINKEFUS
Title or Position: OWNER
Credential:
Phone: 801-597-3294