MEDICARE: LUMINARIA ABA THERAPY 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	251S00000X	Community/Behavioral Health Agency
2	103K00000X	Behavior Analyst

General Provider Information

NPI Number	:	1851240196
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	LUMINARIA ABA THERAPY LLC

Provider Business Mailing Address
First Line	:	2508 GARFIELD AVE SE STE B5
Second Line	:
City	:	ALBUQUERQUE
State	:	NM
Zip	:	87106-3759
Country	:	US
Telephone Number	:	505-385-9472
Fax Number	:

Provider Business Practice Location Address
First Line	:	2508 GARFIELD AVE SE STE B5
Second Line	:
City	:	ALBUQUERQUE
State	:	NM
Zip	:	87106-3759
Country	:	US
Telephone Number	:	505-385-9472
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	ASHER LAX
Credential	:
Telephone Number	:	505-385-9472

Provider Enumeration Date	:	01/28/2026
Last Update Date	:	01/28/2026

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