=====================================================
General NPI Number Information
=====================================================
NPI Number | 1114850591
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | AIRBORNE ABA LLC CO
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 06/05/2026
-----------------------------------------------------
Last Update Date | 06/05/2026
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 405 COLORADO AVE
-----------------------------------------------------
City | LA JUNTA
-----------------------------------------------------
State | CO
-----------------------------------------------------
Zip | 81050-2335
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 720-970-2889
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 2506 LAURELHURST RD
-----------------------------------------------------
City | UNIVERSITY HEIGHTS
-----------------------------------------------------
State | OH
-----------------------------------------------------
Zip | 44118-4612
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 720-970-2889
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | CFO
-----------------------------------------------------
Name | EFRAIM SIMON
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 303-276-5896
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 103K00000X
-----------------------------------------------------
Taxonomy Name | Behavior Analyst
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------