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General NPI Number Information
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NPI Number | 1639029374
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Entity Type | Organization
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Legal Business Name | AVIATION ABA THERAPY NM LLC
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Dates
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Enumeration Date | 02/02/2026
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Last Update Date | 02/02/2026
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Provider Practice Location Address
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Address Line | 6300 RIVERSIDE PLAZA LN NW STE 100
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City | ALBUQUERQUE
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State | NM
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Zip | 87120-1908
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Country | US
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Telephone | 801-875-1317
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Fax |
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Provider Business Mailing Address
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Address Line | 88 WASHINGTON AVE
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City | CEDARHURST
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State | NY
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Zip | 11516-1902
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | REUVEN ROBERTS
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Credential |
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Telephone | 801-875-1317
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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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 | 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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