Provider Demographics
NPI:1952103913
Name:SPIRIT ABA IA LLC
Entity type:Organization
Organization Name:SPIRIT ABA IA LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:MARK
Authorized Official - Middle Name:
Authorized Official - Last Name:MOSKOWITZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:505-295-6685
Mailing Address - Street 1:1601 W LAKES PKWY STE 210
Mailing Address - Street 2:
Mailing Address - City:WEST DES MOINES
Mailing Address - State:IA
Mailing Address - Zip Code:50266-8230
Mailing Address - Country:US
Mailing Address - Phone:347-792-4735
Mailing Address - Fax:
Practice Address - Street 1:1601 W LAKES PKWY STE 210
Practice Address - Street 2:
Practice Address - City:WEST DES MOINES
Practice Address - State:IA
Practice Address - Zip Code:50266-8230
Practice Address - Country:US
Practice Address - Phone:347-792-4735
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-03-27
Last Update Date:2025-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Single Specialty