Healthcare Provider Details

I. General information

NPI: 1811657984
Provider Name (Legal Business Name): ABA GOLDEN STEPS MI LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/30/2021
Last Update Date: 06/20/2024
Certification Date: 06/20/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

100 W BIG BEAVER RD STE 200
TROY MI
48084-5283
US

IV. Provider business mailing address

560 SYLVAN AVE STE 1110
ENGLEWOOD CLIFFS NJ
07632-3118
US

V. Phone/Fax

Practice location:
  • Phone: 615-570-9959
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number
License Number State

VIII. Authorized Official

Name: YISROEL WOLMARK
Title or Position: CEO
Credential:
Phone: 828-351-4466