MEDICARE: BEHAVIOR ANALYSIS TREATMENT SERVICE, 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	252Y00000X	Early Intervention Provider Agency
2	103K00000X	Behavior Analyst

General Provider Information

NPI Number	:	1952115313
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	BEHAVIOR ANALYSIS TREATMENT SERVICE, LLC

Provider Business Mailing Address
First Line	:	3807 FREMONT AVE N
Second Line	:
City	:	MINNEAPOLIS
State	:	MN
Zip	:	55412-2042
Country	:	US
Telephone Number	:	813-335-6788
Fax Number	:

Provider Business Practice Location Address
First Line	:	3807 FREMONT AVE N
Second Line	:
City	:	MINNEAPOLIS
State	:	MN
Zip	:	55412-2042
Country	:	US
Telephone Number	:	813-335-6788
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	DANIEL ALONGI
Credential	:	BCBA
Telephone Number	:	813-335-6788

Provider Enumeration Date	:	02/05/2025
Last Update Date	:	02/05/2025

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