Provider Demographics
NPI:1124733688
Name:BRIGHT START ABA LLC
Entity type:Organization
Organization Name:BRIGHT START ABA LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:FOUNDER
Authorized Official - Prefix:MR
Authorized Official - First Name:OMAR
Authorized Official - Middle Name:
Authorized Official - Last Name:JUDEH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:504-289-3597
Mailing Address - Street 1:9310 ROLLINGWOOD DR
Mailing Address - Street 2:
Mailing Address - City:POMFRET
Mailing Address - State:MD
Mailing Address - Zip Code:20675-3125
Mailing Address - Country:US
Mailing Address - Phone:504-289-3597
Mailing Address - Fax:
Practice Address - Street 1:7 POST OFFICE RD STE M
Practice Address - Street 2:
Practice Address - City:WALDORF
Practice Address - State:MD
Practice Address - Zip Code:20602-2744
Practice Address - Country:US
Practice Address - Phone:504-289-3597
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-01-19
Last Update Date:2023-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Single Specialty
No261Q00000XAmbulatory Health Care FacilitiesClinic/CenterGroup - Single Specialty