Provider Demographics
NPI:1669111639
Name:ADAPTABLE ABA THERAPY LLC
Entity type:Organization
Organization Name:ADAPTABLE ABA THERAPY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BEHAVIOR ANALYST
Authorized Official - Prefix:
Authorized Official - First Name:CHRISA
Authorized Official - Middle Name:
Authorized Official - Last Name:GAMEZ
Authorized Official - Suffix:
Authorized Official - Credentials:BCBA
Authorized Official - Phone:470-430-2571
Mailing Address - Street 1:312 CROSSTOWN DR # 295
Mailing Address - Street 2:
Mailing Address - City:PEACHTREE CITY
Mailing Address - State:GA
Mailing Address - Zip Code:30269-2948
Mailing Address - Country:US
Mailing Address - Phone:470-430-2571
Mailing Address - Fax:470-241-1167
Practice Address - Street 1:205 WATERWOOD BND
Practice Address - Street 2:
Practice Address - City:PEACHTREE CITY
Practice Address - State:GA
Practice Address - Zip Code:30269-1718
Practice Address - Country:US
Practice Address - Phone:323-420-9235
Practice Address - Fax:470-241-1167
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-05-30
Last Update Date:2024-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Single Specialty