Provider Demographics
NPI:1043893241
Name:AKAMAI BEHAVIOR ANALYSIS LLC
Entity Type:Organization
Organization Name:AKAMAI BEHAVIOR ANALYSIS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/THERAPIST
Authorized Official - Prefix:MR
Authorized Official - First Name:MATHEW
Authorized Official - Middle Name:EVAN
Authorized Official - Last Name:FRANK
Authorized Official - Suffix:
Authorized Official - Credentials:EDS
Authorized Official - Phone:808-276-2417
Mailing Address - Street 1:139 HOOWAIWAI LOOP APT 2606
Mailing Address - Street 2:
Mailing Address - City:WAILUKU
Mailing Address - State:HI
Mailing Address - Zip Code:96793-4132
Mailing Address - Country:US
Mailing Address - Phone:808-276-2417
Mailing Address - Fax:808-422-9816
Practice Address - Street 1:139 HOOWAIWAI LOOP APT 2606
Practice Address - Street 2:
Practice Address - City:WAILUKU
Practice Address - State:HI
Practice Address - Zip Code:96793-4132
Practice Address - Country:US
Practice Address - Phone:808-276-2417
Practice Address - Fax:808-422-9816
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-05-04
Last Update Date:2021-05-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251C00000XAgenciesDay Training, Developmentally Disabled Services
Provider Identifiers
StateIdentifier IDID TypeIssuer
HI251C00000XMedicaid