MEDICARE: ADVENTURE ABA LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	103K00000X	Behavior Analyst

General Provider Information

NPI Number	:	1457096505
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ADVENTURE ABA LLC

Provider Business Mailing Address
First Line	:	22 BAYVIEW DR
Second Line	:
City	:	STOCKTON SPRINGS
State	:	ME
Zip	:	04981-4637
Country	:	US
Telephone Number	:	603-513-1526
Fax Number	:

Provider Business Practice Location Address
First Line	:	22 BAYVIEW DR
Second Line	:
City	:	STOCKTON SPRINGS
State	:	ME
Zip	:	04981-4637
Country	:	US
Telephone Number	:	603-513-1526
Fax Number	:

Authorized Official
Title or Position	:	CEO
Name	:	DR. LE'ANN MILINDER
Credential	:	BCBA-D
Telephone Number	:	603-513-1526

Provider Enumeration Date	:	05/03/2022
Last Update Date	:	05/03/2022

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Directions to “ADVENTURE ABA LLC ” Practice Location

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