Healthcare Provider Details
I. General information
NPI: 1730005604
Provider Name (Legal Business Name): MOMENTUM ABA OF OHIO LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 06/25/2026
Last Update Date: 06/25/2026
Certification Date: 06/07/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
815 SUPERIOR AVE STE 1618
CLEVELAND OH
44114-2709
US
IV. Provider business mailing address
3 ASHER DR
SPRING VALLEY NY
10977-2786
US
V. Phone/Fax
- Phone: 845-367-9222
- Fax:
- Phone: 845-367-9222
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 103K00000X |
| Taxonomy | Behavior Analyst |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
YECHIEL
SPREI
Title or Position: OWNER
Credential: BCBA
Phone: 347-563-8828