Provider Demographics
NPI:1952860678
Name:BLUE RIDGE HORIZON ABA LLC
Entity Type:Organization
Organization Name:BLUE RIDGE HORIZON ABA LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CO-OWNER, BCBA
Authorized Official - Prefix:
Authorized Official - First Name:KATHERINE
Authorized Official - Middle Name:
Authorized Official - Last Name:OBLINSKY
Authorized Official - Suffix:
Authorized Official - Credentials:BCBA, LBA
Authorized Official - Phone:484-888-2914
Mailing Address - Street 1:49 QUINCY CT
Mailing Address - Street 2:
Mailing Address - City:STERLING
Mailing Address - State:VA
Mailing Address - Zip Code:20165-5755
Mailing Address - Country:US
Mailing Address - Phone:908-268-9437
Mailing Address - Fax:
Practice Address - Street 1:49 QUINCY CT
Practice Address - Street 2:
Practice Address - City:STERLING
Practice Address - State:VA
Practice Address - Zip Code:20165-5755
Practice Address - Country:US
Practice Address - Phone:908-268-9437
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-03-13
Last Update Date:2019-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
1407303365OtherNPI
1659625325OtherNPI