Provider Demographics
NPI:1629726799
Name:LEAPS AND BOUNDS ABA LLC
Entity Type:Organization
Organization Name:LEAPS AND BOUNDS ABA LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BCBA/ OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:KYLEE
Authorized Official - Middle Name:ELIZABETH
Authorized Official - Last Name:FORDE
Authorized Official - Suffix:
Authorized Official - Credentials:MA, BCBA, LBA
Authorized Official - Phone:727-249-3748
Mailing Address - Street 1:1260 CRAIGLEIGH DR
Mailing Address - Street 2:
Mailing Address - City:NOLENSVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37135-2956
Mailing Address - Country:US
Mailing Address - Phone:727-249-3748
Mailing Address - Fax:
Practice Address - Street 1:1260 CRAIGLEIGH DR
Practice Address - Street 2:
Practice Address - City:NOLENSVILLE
Practice Address - State:TN
Practice Address - Zip Code:37135-2956
Practice Address - Country:US
Practice Address - Phone:272-493-7487
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-03-16
Last Update Date:2022-03-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Single Specialty
No106S00000XBehavioral Health & Social Service ProvidersBehavior TechnicianGroup - Single Specialty