Provider Demographics
NPI:1194455865
Name:ILEAP ABA
Entity Type:Organization
Organization Name:ILEAP ABA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:BASYA
Authorized Official - Middle Name:
Authorized Official - Last Name:GREENSTEIN
Authorized Official - Suffix:
Authorized Official - Credentials:BCBA
Authorized Official - Phone:646-717-1140
Mailing Address - Street 1:239 DOWN HILL RUN
Mailing Address - Street 2:
Mailing Address - City:TOMS RIVER
Mailing Address - State:NJ
Mailing Address - Zip Code:08755-1023
Mailing Address - Country:US
Mailing Address - Phone:646-717-1140
Mailing Address - Fax:
Practice Address - Street 1:239 DOWN HILL RUN
Practice Address - Street 2:
Practice Address - City:TOMS RIVER
Practice Address - State:NJ
Practice Address - Zip Code:08755-1023
Practice Address - Country:US
Practice Address - Phone:646-717-1140
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-06-14
Last Update Date:2022-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Single Specialty