Provider Demographics
NPI:1124876529
Name:FUN WITH ABA, LLC
Entity type:Organization
Organization Name:FUN WITH ABA, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:NADIRAH
Authorized Official - Middle Name:
Authorized Official - Last Name:ALDAYLAM
Authorized Official - Suffix:
Authorized Official - Credentials:MED, BCBA,LBA
Authorized Official - Phone:510-747-2850
Mailing Address - Street 1:4464 LONE TREE WAY # 616
Mailing Address - Street 2:
Mailing Address - City:ANTIOCH
Mailing Address - State:CA
Mailing Address - Zip Code:94531-7413
Mailing Address - Country:US
Mailing Address - Phone:510-747-2850
Mailing Address - Fax:
Practice Address - Street 1:622 ABRAZAR AVE
Practice Address - Street 2:
Practice Address - City:NORTH LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89081-4431
Practice Address - Country:US
Practice Address - Phone:510-747-2850
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-05-09
Last Update Date:2024-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Multi-Specialty