Organization
BEYOND THE SPECTRUM ABA THERAPY, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
AYOOLA O. FADEYI (CEO)
(917) 445-2420
Entity
Organization
Contact information
Practice address
4152 CREEKVIEW BLUFF CT, BUFORD, GA 30518-9215
(917) 445-2420
Mailing address
4152 CREEKVIEW BLUFF CT, BUFORD, GA 30518-9215
(917) 445-2420
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
—
—
251B00000X
Case Management Agency
—
—
251C00000X
Developmentally Disabled Services Day Training Agency
—
—
251S00000X
Community/Behavioral Health Agency
—
—
261Q00000X
Clinic/Center
—
—
261QD1600X
Developmental Disabilities Clinic/Center
—
—
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
—
—
261QM0855X
Adolescent and Children Mental Health Clinic/Center
Primary
—
—
Other
Enumeration date
11/06/2024
Last updated
11/06/2024
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