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NPI Code Detail

MEDICARE: AVIATION ABA THERAPY NM LLC

MEDICARE: AVIATION ABA THERAPY NM 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
1251S00000XCommunity/Behavioral Health Agency
2103K00000XBehavior Analyst

General Provider Information

NPI Number : 1639029374
Entity Type Code : Organization
Provider Name (Legal Business Name) : AVIATION ABA THERAPY NM LLC
Provider Business Mailing Address
First Line : 88 WASHINGTON AVE
Second Line :
City : CEDARHURST
State : NY
Zip : 11516-1902
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 6300 RIVERSIDE PLAZA LN NW STE 100
Second Line :
City : ALBUQUERQUE
State : NM
Zip : 87120-1908
Country : US
Telephone Number : 801-875-1317
Fax Number :
Authorized Official
Title or Position : CEO
Name : REUVEN ROBERTS
Credential :
Telephone Number : 801-875-1317
Provider Enumeration Date : 02/02/2026
Last Update Date : 02/02/2026

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Directions to “AVIATION ABA THERAPY NM LLC ” Practice Location

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