Healthcare Provider Details
I. General information
NPI: 1215845151
Provider Name (Legal Business Name): AMAZE ABA MISSOURI
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 08/31/2026
Last Update Date: 08/31/2026
Certification Date: 08/31/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
100 CHESTERFIELD BUSINESS PKWY
CHESTERFIELD MO
63005-1208
US
IV. Provider business mailing address
100 CHESTERFIELD BUSINESS PKWY FL 2
CHESTERFIELD MO
63005-1271
US
V. Phone/Fax
- Phone: 855-613-2025
- Fax:
- Phone:
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 103K00000X |
| Taxonomy | Behavior Analyst |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
JOSEPH
SCHWARTZ
Title or Position: DIRECTOR
Credential:
Phone: 917-828-1809