Provider Demographics
NPI:1619763588
Name:TAKE HEART ABA LLC
Entity type:Organization
Organization Name:TAKE HEART ABA LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/AUTHORIZED OFFICIAL
Authorized Official - Prefix:
Authorized Official - First Name:ANNA
Authorized Official - Middle Name:ELIZABETH
Authorized Official - Last Name:VINCENT
Authorized Official - Suffix:
Authorized Official - Credentials:BCBA
Authorized Official - Phone:770-696-8189
Mailing Address - Street 1:35 FIRST ST
Mailing Address - Street 2:
Mailing Address - City:HOSCHTON
Mailing Address - State:GA
Mailing Address - Zip Code:30548-2234
Mailing Address - Country:US
Mailing Address - Phone:770-696-8189
Mailing Address - Fax:
Practice Address - Street 1:35 FIRST ST
Practice Address - Street 2:
Practice Address - City:HOSCHTON
Practice Address - State:GA
Practice Address - Zip Code:30548-2234
Practice Address - Country:US
Practice Address - Phone:770-696-8189
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-04-17
Last Update Date:2025-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Single Specialty