Provider Demographics
NPI:1033855150
Name:GOLDEN STARS ABA, INC.
Entity Type:Organization
Organization Name:GOLDEN STARS ABA, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:IDARA
Authorized Official - Middle Name:
Authorized Official - Last Name:USORO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:713-408-0672
Mailing Address - Street 1:PO BOX 2269
Mailing Address - Street 2:
Mailing Address - City:STAFFORD
Mailing Address - State:TX
Mailing Address - Zip Code:77497-2269
Mailing Address - Country:US
Mailing Address - Phone:713-408-0672
Mailing Address - Fax:
Practice Address - Street 1:2111 WEST LOOP SOUTH
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77027
Practice Address - Country:US
Practice Address - Phone:713-408-0672
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-05-11
Last Update Date:2022-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Single Specialty
No251S00000XAgenciesCommunity/Behavioral HealthGroup - Single Specialty