Healthcare Provider Details

I. General information

NPI: 1346155843
Provider Name (Legal Business Name): VIBRANT ABA ID LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/18/2026
Last Update Date: 08/18/2026
Certification Date: 08/18/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3597 E MONARCH SKY LN
MERIDIAN ID
83646-1053
US

IV. Provider business mailing address

3597 E MONARCH SKY LN
MERIDIAN ID
83646-1053
US

V. Phone/Fax

Practice location:
  • Phone: 704-818-0207
  • Fax:
Mailing address:
  • Phone: 704-818-0207
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: ARON GREENFELD
Title or Position: DIRECTOR
Credential:
Phone: 551-233-8603