Healthcare Provider Details

I. General information

NPI: 1871454348
Provider Name (Legal Business Name): EDENPATH ABA MARYLAND LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/24/2025
Last Update Date: 02/21/2026
Certification Date: 02/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

400 E PRATT STREET FL 8
BALTIMORE MD
21202-3180
US

IV. Provider business mailing address

400 E PRATT STREET FL 8
BALTIMORE MD
21202-3180
US

V. Phone/Fax

Practice location:
  • Phone: 301-673-3575
  • Fax: 866-510-5010
Mailing address:
  • Phone:
  • Fax: 866-510-5010

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State

VIII. Authorized Official

Name: MR. CHAIM GOBIOFF
Title or Position: OWNER
Credential:
Phone: 917-300-8074