MEDICARE: LEAPFROG ABA LV 1 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	261QM0855X	Adolescent and Children Mental Health Clinic/Center
2	103K00000X	Behavior Analyst

General Provider Information

NPI Number	:	1871342022
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	LEAPFROG ABA LV 1 LLC

Provider Business Mailing Address
First Line	:	3087 E WARM SPRINGS RD STE 300
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89120-3754
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	3037 E WARM SPRINGS RD STE 300
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89120-3759
Country	:	US
Telephone Number	:	702-587-3131
Fax Number	:

Authorized Official
Title or Position	:	BUSINESS DIRECTOR
Name	:	MELISSA DEMARRIAS
Credential	:
Telephone Number	:	702-587-3131

Provider Enumeration Date	:	05/17/2024
Last Update Date	:	12/03/2025

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