Provider Demographics
NPI:1316638018
Name:RADIANT MINDS ABA LLC
Entity type:Organization
Organization Name:RADIANT MINDS ABA LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CO-CEO
Authorized Official - Prefix:
Authorized Official - First Name:TYLER
Authorized Official - Middle Name:
Authorized Official - Last Name:TAUFER
Authorized Official - Suffix:
Authorized Official - Credentials:MA
Authorized Official - Phone:808-284-7328
Mailing Address - Street 1:103 W GENERAL SCREVEN WAY
Mailing Address - Street 2:STE G PMB 1098
Mailing Address - City:HINESVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:31313-2881
Mailing Address - Country:US
Mailing Address - Phone:808-284-7328
Mailing Address - Fax:
Practice Address - Street 1:481 ELMA G MILES PKWY STE B
Practice Address - Street 2:
Practice Address - City:HINESVILLE
Practice Address - State:GA
Practice Address - Zip Code:31313-4004
Practice Address - Country:US
Practice Address - Phone:808-284-7328
Practice Address - Fax:912-221-3085
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-05-15
Last Update Date:2023-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Single Specialty