MEDICARE: GOLD STANDARD ABA MO 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	:	1649071184
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	GOLD STANDARD ABA MO LLC

Provider Business Mailing Address
First Line	:	229 ROUTE 70 STE 100
Second Line	:
City	:	TOMS RIVER
State	:	NJ
Zip	:	08755-1026
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1701 TROOST AVE
Second Line	:
City	:	KANSAS CITY
State	:	MO
Zip	:	64108-1540
Country	:	US
Telephone Number	:	857-327-5283
Fax Number	:

Authorized Official
Title or Position	:	CEO
Name	:	CHAIM KAUFMAN
Credential	:
Telephone Number	:	857-327-5283

Provider Enumeration Date	:	03/21/2025
Last Update Date	:	03/21/2025

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