Healthcare Provider Details

I. General information

NPI: 1144182072
Provider Name (Legal Business Name): ADMIRE ABA NC LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/01/2025
Last Update Date: 12/01/2025
Certification Date: 11/30/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4030 WAKE FOREST RD
RALEIGH NC
27609-0010
US

IV. Provider business mailing address

18 SEA POINT DR
LAKEWOOD NJ
08701-4341
US

V. Phone/Fax

Practice location:
  • Phone: 732-930-3282
  • Fax:
Mailing address:
  • Phone: 732-930-3282
  • 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 Code103T00000X
TaxonomyPsychologist
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code106E00000X
TaxonomyAssistant Behavior Analyst
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number
License Number State

VIII. Authorized Official

Name: RALPH MOLLER
Title or Position: CEO
Credential:
Phone: 732-930-3282