Provider Demographics
NPI:1871260810
Name:SHIFT, LLC
Entity Type:Organization
Organization Name:SHIFT, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JENNIFER
Authorized Official - Middle Name:JEAN
Authorized Official - Last Name:ABEL
Authorized Official - Suffix:
Authorized Official - Credentials:BCBA, LBA
Authorized Official - Phone:701-830-0388
Mailing Address - Street 1:26946 464TH AVE
Mailing Address - Street 2:
Mailing Address - City:TEA
Mailing Address - State:SD
Mailing Address - Zip Code:57064-8033
Mailing Address - Country:US
Mailing Address - Phone:701-830-0388
Mailing Address - Fax:
Practice Address - Street 1:26946 464TH AVE
Practice Address - Street 2:
Practice Address - City:TEA
Practice Address - State:SD
Practice Address - Zip Code:57064-8033
Practice Address - Country:US
Practice Address - Phone:701-830-0388
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-08-26
Last Update Date:2021-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Single Specialty