NPIMap

Organization Active NPI

Mission Momentum ABA, Inc.

  • Behavior Analyst
  • Grand Island, FL
National Provider Identifier
1194415612
Registry record updated May 9, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior AnalystTaxonomy code 103K00000X
Legal business name
MISSION MOMENTUM ABA, INC.
Practice address
2475 Plumadore Dr
Grand Island, FL 32735-9012
Phone
(321) 279-2443
NPI assigned
May 9, 2023
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 9, 2023

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Brooke ManionNPI 1508150962
Title
Bcba
Phone
(321) 279-2443

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior AnalystGroup: 193400000X SINGLE SPECIALTY GROUP 103K00000X Primary

Addresses

Primary practice location

2475 Plumadore Dr
Grand Island, FL 32735-9012

Mailing address

2475 Plumadore Dr
Grand Island, FL 32735-9012
Phone (321) 279-2443

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1683590400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1683590400000",
    "number": "1194415612",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2475 PLUMADORE DR",
            "city": "GRAND ISLAND",
            "state": "FL",
            "postal_code": "327359012",
            "telephone_number": "321-279-2443"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2475 PLUMADORE DR",
            "city": "GRAND ISLAND",
            "state": "FL",
            "postal_code": "327359012",
            "telephone_number": "321-279-2443"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MISSION MOMENTUM ABA, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-05-09",
        "last_updated": "2023-05-09",
        "certification_date": "2023-05-09",
        "status": "A",
        "authorized_official_last_name": "MANION",
        "authorized_official_first_name": "BROOKE",
        "authorized_official_title_or_position": "BCBA",
        "authorized_official_telephone_number": "321-279-2443"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Behavior Analyst",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Grand Island, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 9, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.