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General NPI Number Information
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NPI Number | 1659953164
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Entity Type | Organization
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Legal Business Name | INSPIRE ABA SERVICES LLC
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Dates
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Enumeration Date | 04/23/2021
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Last Update Date | 04/23/2021
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Provider Practice Location Address
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Address Line | 805 OAKHURST DR
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City | EVANS
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State | GA
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Zip | 30809-3712
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Country | US
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Telephone | 706-572-6031
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Fax | 762-224-0104
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Provider Business Mailing Address
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Address Line | 5549 CONNOR DR
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City | EVANS
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State | GA
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Zip | 30809-6164
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Country | US
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Telephone | 706-572-6031
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Fax | 762-224-0104
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Authorized Official
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Title or Position | BCBA/OWNER
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Name | MRS. ALICIA A YOSHIMOTO
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Credential | MA, BCBA
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Telephone | 706-572-6031
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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 | 261QD1600X
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Taxonomy Name | Developmental Disabilities Clinic/Center
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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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