MEDICARE: AHEAD ABA KS

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	:	1790612752
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	AHEAD ABA KS

Provider Business Mailing Address
First Line	:	1 GREEN HILL LN
Second Line	:
City	:	SPRING VALLEY
State	:	NY
Zip	:	10977-1608
Country	:	US
Telephone Number	:	929-884-1068
Fax Number	:

Provider Business Practice Location Address
First Line	:	4601 E DOUGLAS AVE STE 150
Second Line	:
City	:	WICHITA
State	:	KS
Zip	:	67218-1011
Country	:	US
Telephone Number	:	929-884-1068
Fax Number	:

Authorized Official
Title or Position	:	CEO
Name	:	JUDAH EDELSTEIN
Credential	:
Telephone Number	:	929-884-1068

Provider Enumeration Date	:	05/05/2026
Last Update Date	:	05/05/2026

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Directions to “AHEAD ABA KS ” Practice Location

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