Healthcare Provider Details

I. General information

NPI: 1629964416
Provider Name (Legal Business Name): AFFECTION ABA LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/17/2025
Last Update Date: 06/17/2025
Certification Date: 06/17/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2807 N PARHAM RD STE 320
HENRICO VA
23294-4458
US

IV. Provider business mailing address

2807 N PARHAM RD STE 320
HENRICO VA
23294-4458
US

V. Phone/Fax

Practice location:
  • Phone: 305-900-7029
  • Fax:
Mailing address:
  • Phone: 305-900-7029
  • 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 Code106E00000X
TaxonomyAssistant Behavior Analyst
License Number
License Number State

VIII. Authorized Official

Name: YOSEF ELIYAHU BENMERGUI
Title or Position: DIRECTOR
Credential:
Phone: 305-900-7029