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General NPI Number Information
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NPI Number | 1699583310
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Entity Type | Organization
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Legal Business Name | MIND RISE ABA VA LLC
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Dates
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Enumeration Date | 12/27/2024
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Last Update Date | 12/27/2024
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Provider Practice Location Address
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Address Line | 2003 PLANK RD # 1028
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City | FREDERICKSBURG
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State | VA
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Zip | 22401-5103
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Country | US
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Telephone | 732-677-4124
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Fax |
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Provider Business Mailing Address
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Address Line | 701 WELLINGTON AVE
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City | TOMS RIVER
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State | NJ
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Zip | 08757-1310
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Country | US
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Telephone | 732-677-4124
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | AVRAHAM MEISTER
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Credential |
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Telephone | 732-677-4124
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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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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