Provider Demographics
NPI:1811556087
Name:BRILLIANT STARS ABA, LLC
Entity Type:Organization
Organization Name:BRILLIANT STARS ABA, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:SETAREH
Authorized Official - Middle Name:DEHGHANI
Authorized Official - Last Name:MOSLEMI
Authorized Official - Suffix:
Authorized Official - Credentials:BCBA
Authorized Official - Phone:408-666-7363
Mailing Address - Street 1:2301 LEEWARD PL
Mailing Address - Street 2:
Mailing Address - City:LITTLE ELM
Mailing Address - State:TX
Mailing Address - Zip Code:75068-6319
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:2301 LEEWARD PL
Practice Address - Street 2:
Practice Address - City:LITTLE ELM
Practice Address - State:TX
Practice Address - Zip Code:75068-6319
Practice Address - Country:US
Practice Address - Phone:408-666-7363
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-06-11
Last Update Date:2022-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Multi-Specialty