Provider Demographics
NPI:1659182822
Name:LEAP ABA LLC
Entity type:Organization
Organization Name:LEAP ABA LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINICAL DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:ADNER
Authorized Official - Middle Name:
Authorized Official - Last Name:COLON
Authorized Official - Suffix:
Authorized Official - Credentials:BCBA
Authorized Official - Phone:973-883-5850
Mailing Address - Street 1:4729 PEACHTREE INDUSTRIAL BLVD STE 300
Mailing Address - Street 2:
Mailing Address - City:BERKELEY LAKE
Mailing Address - State:GA
Mailing Address - Zip Code:30092-3023
Mailing Address - Country:US
Mailing Address - Phone:470-719-8976
Mailing Address - Fax:
Practice Address - Street 1:4729 PEACHTREE INDUSTRIAL BLVD STE 300
Practice Address - Street 2:
Practice Address - City:BERKELEY LAKE
Practice Address - State:GA
Practice Address - Zip Code:30092-3023
Practice Address - Country:US
Practice Address - Phone:470-719-8976
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-01-16
Last Update Date:2025-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Single Specialty