Provider Demographics
NPI:1982287090
Name:GIFTED MINDS ABA PROGRAM LLC.
Entity Type:Organization
Organization Name:GIFTED MINDS ABA PROGRAM LLC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:STEVEN
Authorized Official - Middle Name:JAY
Authorized Official - Last Name:REMMENGA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:956-320-3716
Mailing Address - Street 1:6363 GROVER ST TRLR 33
Mailing Address - Street 2:
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68106-4318
Mailing Address - Country:US
Mailing Address - Phone:956-320-3716
Mailing Address - Fax:
Practice Address - Street 1:6363 GROVER ST TRLR 33
Practice Address - Street 2:
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68106-4318
Practice Address - Country:US
Practice Address - Phone:956-320-3716
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-05-05
Last Update Date:2021-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Single Specialty