Provider Demographics
NPI:1326762741
Name:AMBITIONS ABA LLC
Entity Type:Organization
Organization Name:AMBITIONS ABA LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:COO
Authorized Official - Prefix:
Authorized Official - First Name:YITZ
Authorized Official - Middle Name:
Authorized Official - Last Name:DIENA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:732-399-9570
Mailing Address - Street 1:6633 N LINCOLN AVE
Mailing Address - Street 2:
Mailing Address - City:LINCOLNWOOD
Mailing Address - State:IL
Mailing Address - Zip Code:60712-3605
Mailing Address - Country:US
Mailing Address - Phone:773-399-9570
Mailing Address - Fax:
Practice Address - Street 1:6633 N LINCOLN AVE
Practice Address - Street 2:
Practice Address - City:LINCOLNWOOD
Practice Address - State:IL
Practice Address - Zip Code:60712-3605
Practice Address - Country:US
Practice Address - Phone:773-399-9570
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-09-29
Last Update Date:2022-09-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Multi-Specialty