Healthcare Provider Details

I. General information

NPI: 1417804980
Provider Name (Legal Business Name): AIRBORNE ABA NM LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/13/2026
Last Update Date: 06/10/2026
Certification Date: 06/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

400 GOLD AVE SW STE 708
ALBUQUERQUE NM
87102-3283
US

IV. Provider business mailing address

4405 JAGER DR NE STE C4
RIO RANCHO NM
87144-5715
US

V. Phone/Fax

Practice location:
  • Phone: 720-970-2889
  • 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: EFRAIM SIMON
Title or Position: CFO
Credential: SIMON
Phone: 848-373-6394