Organization
ALL STAR ABA VA LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SHAWN TYBERG (DIRECTOR)
(718) 600-6604
Entity
Organization
Contact information
Practice address
4410 CLAIBORNE SQ E STE 334, HAMPTON, VA 23666-2074
(410) 541-1316
Mailing address
4410 CLAIBORNE SQ E STE 334, HAMPTON, VA 23666-2074
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Enumeration date
02/02/2024
Last updated
02/02/2024
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