Provider Demographics
NPI:1194448357
Name:ALIEN ABA LLC
Entity type:Organization
Organization Name:ALIEN ABA LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ANDREW
Authorized Official - Middle Name:
Authorized Official - Last Name:DEVITT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:702-505-2864
Mailing Address - Street 1:7061 W ARBY AVE STE 170
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89113-4464
Mailing Address - Country:US
Mailing Address - Phone:702-505-2864
Mailing Address - Fax:
Practice Address - Street 1:7061 W ARBY AVE STE 170
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89113-4464
Practice Address - Country:US
Practice Address - Phone:702-505-2864
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-09-22
Last Update Date:2022-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health