Healthcare Provider Details

I. General information

NPI: 1649122797
Provider Name (Legal Business Name): SHINING STEPS ABA OF IDAHO LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/11/2026
Last Update Date: 02/11/2026
Certification Date: 02/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

784 S CLEARWATER LOOP STE R
POST FALLS ID
83854-9599
US

IV. Provider business mailing address

2941 W FARGO AVE
CHICAGO IL
60645-1222
US

V. Phone/Fax

Practice location:
  • Phone: 872-203-3994
  • Fax:
Mailing address:
  • Phone: 872-203-3994
  • 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: ASHER STEIN
Title or Position: CFO
Credential:
Phone: 872-203-3994