Provider Demographics
NPI:1558103747
Name:GROWING MINDS ABA THERAPY LLC
Entity type:Organization
Organization Name:GROWING MINDS ABA THERAPY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF EXECUTIVE OFFICER
Authorized Official - Prefix:MRS
Authorized Official - First Name:YARA
Authorized Official - Middle Name:
Authorized Official - Last Name:FELDER
Authorized Official - Suffix:
Authorized Official - Credentials:MA
Authorized Official - Phone:818-521-2315
Mailing Address - Street 1:4700 NATICK AVE UNIT 110
Mailing Address - Street 2:
Mailing Address - City:SHERMAN OAKS
Mailing Address - State:CA
Mailing Address - Zip Code:91403-2730
Mailing Address - Country:US
Mailing Address - Phone:818-521-2315
Mailing Address - Fax:
Practice Address - Street 1:4700 NATICK AVE UNIT 110
Practice Address - Street 2:
Practice Address - City:SHERMAN OAKS
Practice Address - State:CA
Practice Address - Zip Code:91403-2730
Practice Address - Country:US
Practice Address - Phone:818-521-2315
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-06-10
Last Update Date:2024-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251C00000XAgenciesDay Training, Developmentally Disabled Services