Provider Demographics
NPI:1275185654
Name:LIVING HOPE ABA THERAPY, INC (A PROFESSIONAL CORPORATION)
Entity Type:Organization
Organization Name:LIVING HOPE ABA THERAPY, INC (A PROFESSIONAL CORPORATION)
Other - Org Name:AMANDA GALLAND
Other - Org Type:Doing Business As
Authorized Official - Title/Position:BCBA,LBA,CEO
Authorized Official - Prefix:
Authorized Official - First Name:AMANDA
Authorized Official - Middle Name:M
Authorized Official - Last Name:GALLAND
Authorized Official - Suffix:
Authorized Official - Credentials:BCBA,LBA
Authorized Official - Phone:337-322-4275
Mailing Address - Street 1:3127 HIGHWAY 457
Mailing Address - Street 2:
Mailing Address - City:ALEXANDRIA
Mailing Address - State:LA
Mailing Address - Zip Code:71302-9256
Mailing Address - Country:US
Mailing Address - Phone:337-322-4275
Mailing Address - Fax:
Practice Address - Street 1:3127 HIGHWAY 457
Practice Address - Street 2:
Practice Address - City:ALEXANDRIA
Practice Address - State:LA
Practice Address - Zip Code:71302-9256
Practice Address - Country:US
Practice Address - Phone:337-322-4275
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-07-15
Last Update Date:2019-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Single Specialty