Healthcare Provider Details

I. General information

NPI: 1871342022
Provider Name (Legal Business Name): LEAPFROG ABA LV 1 LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/17/2024
Last Update Date: 12/03/2025
Certification Date: 12/03/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3037 E WARM SPRINGS RD STE 300
LAS VEGAS NV
89120-3759
US

IV. Provider business mailing address

3087 E WARM SPRINGS RD STE 300
LAS VEGAS NV
89120-3754
US

V. Phone/Fax

Practice location:
  • Phone: 702-587-3131
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code261QM0855X
TaxonomyAdolescent and Children Mental Health Clinic/Center
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number
License Number State

VIII. Authorized Official

Name: MELISSA DEMARRIAS
Title or Position: BUSINESS DIRECTOR
Credential:
Phone: 702-587-3131