Healthcare Provider Details

I. General information

NPI: 1437082203
Provider Name (Legal Business Name): STARLIGHT ABA KS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/03/2026
Last Update Date: 06/03/2026
Certification Date: 06/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12345 W 95TH ST FL 2
LENEXA KS
66215-3853
US

IV. Provider business mailing address

12345 W 95TH ST FL 2
LENEXA KS
66215-3853
US

V. Phone/Fax

Practice location:
  • Phone: 877-888-8740
  • Fax: 877-888-8740
Mailing address:
  • Phone: 877-888-8740
  • 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: ABRAHAM TYBERG
Title or Position: DIRECTOR
Credential:
Phone: 877-888-8740