Your Life Aba Va, Llc | |
1314 Riverland Rd Se Roanoke VA 24014-3610 | |
(866) 565-7222 | |
(877) 734-1914 |
Full Name | Your Life Aba Va, Llc |
---|---|
Speciality | Behavior Analyst |
Location | 1314 Riverland Rd Se, Roanoke, Virginia |
Authorized Official Name and Position | Ed Donovan (VP, RCM) |
Authorized Official Contact | 6105004945 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
---|---|
Your Life Aba Va, Llc 2 Village Sq Ste 210 Baltimore MD 21210-1624 Ph: (609) 525-4271 | Your Life Aba Va, Llc 1314 Riverland Rd Se Roanoke VA 24014-3610 Ph: (866) 565-7222 |
NPI Number | 1023772001 |
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Provider Enumeration Date | 10/26/2021 |
Last Update Date | 03/28/2024 |
Certification Date | 03/28/2024 |
Identifier | Type | State | Issuer |
---|---|---|---|
1023772001 | NPI | - | NPPES |
1023772001 | Medicaid | VA |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
103K00000X | Behavior Analyst | (* (Not Available)) | Primary |
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