=====================================================
General NPI Number Information
=====================================================
NPI Number | 1235946302
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | A LEAP OF ABA, LLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 12/12/2024
-----------------------------------------------------
Last Update Date | 12/24/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 2003 CHEATHAM WOODS DR SW
-----------------------------------------------------
City | MARIETTA
-----------------------------------------------------
State | GA
-----------------------------------------------------
Zip | 30008-4451
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 470-899-2989
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 2003 CHEATHAM WOODS DR SW
-----------------------------------------------------
City | MARIETTA
-----------------------------------------------------
State | GA
-----------------------------------------------------
Zip | 30008-4451
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 404-594-0519
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | CO OWNER
-----------------------------------------------------
Name | GLEN ILUNGA
-----------------------------------------------------
Credential | BCBA
-----------------------------------------------------
Telephone | 470-363-3934
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 103K00000X
-----------------------------------------------------
Taxonomy Name | Behavior Analyst
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------