Provider Demographics
NPI: | 1689485922 |
---|---|
Name: | BE UNIQUE ABA LLC |
Entity type: | Organization |
Organization Name: | BE UNIQUE ABA LLC |
Other - Org Name: | |
Other - Org Type: | |
Authorized Official - Title/Position: | MANAGING MEMBER/DIRECTOR |
Authorized Official - Prefix: | |
Authorized Official - First Name: | BEAU |
Authorized Official - Middle Name: | DANIEL CORBRIDGE |
Authorized Official - Last Name: | RITCHIE |
Authorized Official - Suffix: | |
Authorized Official - Credentials: | |
Authorized Official - Phone: | 626-297-5284 |
Mailing Address - Street 1: | 800 WAGON TRAIN DR SE |
Mailing Address - Street 2: | |
Mailing Address - City: | ALBUQUERQUE |
Mailing Address - State: | NM |
Mailing Address - Zip Code: | 87123-4140 |
Mailing Address - Country: | US |
Mailing Address - Phone: | 626-297-5284 |
Mailing Address - Fax: | |
Practice Address - Street 1: | 800 WAGON TRAIN DR SE |
Practice Address - Street 2: | |
Practice Address - City: | ALBUQUERQUE |
Practice Address - State: | NM |
Practice Address - Zip Code: | 87123-4140 |
Practice Address - Country: | US |
Practice Address - Phone: | 626-297-5284 |
Practice Address - Fax: | |
EIN: | <UNAVAIL> |
Is Organization Subpart?: | No |
Parent Organization LBN: | |
Parent Organization TIN: | |
Enumeration Date: | 2025-01-16 |
Last Update Date: | 2025-01-16 |
Deactivation Date: | |
Deactivation Code: | |
Reactivation Date: |
Provider Taxonomies
Primary? | Code | Type | Classification | Specialization | Group |
---|---|---|---|---|---|
Yes | 103K00000X | Behavioral Health & Social Service Providers | Behavior Analyst | Group - Multi-Specialty | |
No | 251S00000X | Agencies | Community/Behavioral Health |