Healthcare Provider Details

I. General information

NPI: 1700707395
Provider Name (Legal Business Name): UPSTREAM ABA MISSOURI LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/21/2026
Last Update Date: 07/21/2026
Certification Date: 07/13/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7280 NW 87TH TER STE C-210
KANSAS CITY MO
64153-3720
US

IV. Provider business mailing address

244 5TH AVE STE A271
NEW YORK NY
10001-7604
US

V. Phone/Fax

Practice location:
  • Phone: 706-389-4307
  • 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

VIII. Authorized Official

Name: ADAM ZAUDERER
Title or Position: CEO
Credential:
Phone: 706-389-4307