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General NPI Number Information
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NPI Number | 1346984812
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Entity Type | Organization
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Legal Business Name | SILVER STATE ABA LLC
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Dates
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Enumeration Date | 04/21/2022
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Last Update Date | 05/17/2023
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Provider Practice Location Address
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Address Line | 8270 W CHARLESTON BLVD
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City | LAS VEGAS
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State | NV
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Zip | 89117-1219
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Country | US
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Telephone | 702-350-1875
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Fax | 833-901-4030
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Provider Business Mailing Address
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Address Line | 8270 W CHARLESTON BLVD
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City | LAS VEGAS
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State | NV
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Zip | 89117-1219
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Country | US
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Telephone | 702-350-1875
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Fax | 833-901-4030
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Authorized Official
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Title or Position | PRESIDENT
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Name | BROOK MADDEN
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Credential | BCBA, LBA
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Telephone | 702-350-1875
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 106E00000X
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Taxonomy Name | Assistant Behavior Analyst
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 106S00000X
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Taxonomy Name | Behavior Technician
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 103K00000X
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Taxonomy Name | Behavior Analyst
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License Number |
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License Number State |
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