Evergreen Aba LLC

NPI #1558128553 in Bentonville, Arkansas

Provider Information

NPI Number: 1558128553
Entity Type: Organization
Organization Name: Evergreen Aba LLC
Subpart: Yes (part of a larger organization)
Parent Organization: LATITUDE ABA HOLDINGS LLC
Primary Specialty: Behavior Analyst
Enumeration Date: Mar 5, 2024
Last Updated: Nov 7, 2024

Practice Location

Address: 900 SE 5TH STREET
City: Bentonville
State: Arkansas
ZIP Code: 72712
Phone: (314) 410-9670

Authorized Official

Name: TALIA SCHUSS
Title: CEO
Phone: (314) 410-9670

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Community/Behavioral Health	251S00000X
Behavior Analyst	103K00000X	Primary

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