Provider Demographics
NPI:1740992262
Name:IMPACT ABA SERVICES, LLC
Entity type:Organization
Organization Name:IMPACT ABA SERVICES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:MEGAN
Authorized Official - Middle Name:
Authorized Official - Last Name:MCGREW
Authorized Official - Suffix:
Authorized Official - Credentials:PHD, BCBA, LBA
Authorized Official - Phone:775-376-9426
Mailing Address - Street 1:2395 LINCOLN MEADOWS DR
Mailing Address - Street 2:
Mailing Address - City:RENO
Mailing Address - State:NV
Mailing Address - Zip Code:89521-5252
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:5345 RENO CORPORATE DR
Practice Address - Street 2:
Practice Address - City:RENO
Practice Address - State:NV
Practice Address - Zip Code:89511-2381
Practice Address - Country:US
Practice Address - Phone:775-376-9426
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:IMPACT ABA SERVICES, LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2022-12-15
Last Update Date:2022-12-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes385H00000XRespite Care FacilityRespite Care