Provider Demographics
NPI: | 1730921099 |
---|---|
Name: | FOUNDATIONS ABA, LLC |
Entity type: | Organization |
Organization Name: | FOUNDATIONS ABA, LLC |
Other - Org Name: | |
Other - Org Type: | |
Authorized Official - Title/Position: | MANAGING DIRECTOR |
Authorized Official - Prefix: | |
Authorized Official - First Name: | SHAKIA |
Authorized Official - Middle Name: | T |
Authorized Official - Last Name: | PINKNEY JONES |
Authorized Official - Suffix: | |
Authorized Official - Credentials: | |
Authorized Official - Phone: | 352-327-5462 |
Mailing Address - Street 1: | 3521 SE 22ND PL |
Mailing Address - Street 2: | |
Mailing Address - City: | GAINESVILLE |
Mailing Address - State: | FL |
Mailing Address - Zip Code: | 32641-9137 |
Mailing Address - Country: | US |
Mailing Address - Phone: | |
Mailing Address - Fax: | |
Practice Address - Street 1: | 3521 SE 22ND PL |
Practice Address - Street 2: | |
Practice Address - City: | GAINESVILLE |
Practice Address - State: | FL |
Practice Address - Zip Code: | 32641-9137 |
Practice Address - Country: | US |
Practice Address - Phone: | 352-327-5462 |
Practice Address - Fax: | |
EIN: | <UNAVAIL> |
Is Organization Subpart?: | No |
Parent Organization LBN: | |
Parent Organization TIN: | |
Enumeration Date: | 2024-06-08 |
Last Update Date: | 2025-01-06 |
Deactivation Date: | |
Deactivation Code: | |
Reactivation Date: |
Provider Taxonomies
Primary? | Code | Type | Classification | Specialization | Group |
---|---|---|---|---|---|
Yes | 103K00000X | Behavioral Health & Social Service Providers | Behavior Analyst | Group - Single Specialty | |
No | 252Y00000X | Agencies | Early Intervention Provider Agency | Group - Single Specialty |