=====================================================
General NPI Number Information
=====================================================
NPI Number | 1649122797
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | SHINING STEPS ABA OF IDAHO LLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 02/11/2026
-----------------------------------------------------
Last Update Date | 02/11/2026
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 784 S CLEARWATER LOOP STE R
-----------------------------------------------------
City | POST FALLS
-----------------------------------------------------
State | ID
-----------------------------------------------------
Zip | 83854-9599
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 872-203-3994
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 2941 W FARGO AVE
-----------------------------------------------------
City | CHICAGO
-----------------------------------------------------
State | IL
-----------------------------------------------------
Zip | 60645-1222
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 872-203-3994
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | CFO
-----------------------------------------------------
Name | ASHER STEIN
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 872-203-3994
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 103K00000X
-----------------------------------------------------
Taxonomy Name | Behavior Analyst
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------