Provider Demographics
NPI:1346967312
Name:RAYN ABA LLC
Entity Type:Organization
Organization Name:RAYN ABA LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:AUDREY
Authorized Official - Middle Name:NICOLE
Authorized Official - Last Name:RAYNOR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:210-993-0212
Mailing Address - Street 1:5009 CASCADE POOLS AVE
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89131-3626
Mailing Address - Country:US
Mailing Address - Phone:210-993-0212
Mailing Address - Fax:
Practice Address - Street 1:8414 FARM RD
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89131-8170
Practice Address - Country:US
Practice Address - Phone:210-993-0212
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-10-20
Last Update Date:2022-10-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health