Provider Demographics
NPI:1952079592
Name:UMBRELLA ABA
Entity Type:Organization
Organization Name:UMBRELLA ABA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:
Authorized Official - Last Name:CHARLIYAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:818-257-8959
Mailing Address - Street 1:16756 RINALDI ST
Mailing Address - Street 2:
Mailing Address - City:GRANADA HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:91344-3633
Mailing Address - Country:US
Mailing Address - Phone:833-474-8222
Mailing Address - Fax:833-474-8222
Practice Address - Street 1:16501 VENTURA BLVD STE 400
Practice Address - Street 2:
Practice Address - City:ENCINO
Practice Address - State:CA
Practice Address - Zip Code:91436-2067
Practice Address - Country:US
Practice Address - Phone:833-474-8222
Practice Address - Fax:833-474-8222
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-08-30
Last Update Date:2021-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Single Specialty