Healthcare Provider Details

I. General information

NPI: 1386593572
Provider Name (Legal Business Name): SPIRIT ABA NM LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/22/2026
Last Update Date: 01/22/2026
Certification Date: 01/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

500 MARQUETTE AVE NW STE 1200
ALBUQUERQUE NM
87102-5312
US

IV. Provider business mailing address

500 MARQUETTE AVE NW STE 1200
ALBUQUERQUE NM
87102-5312
US

V. Phone/Fax

Practice location:
  • Phone: 303-276-3995
  • 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: MARK KAUFMAN
Title or Position: DIRECTOR
Credential:
Phone: 303-276-3995