Gulfport Premier ABA LLC

Organization Active NPI Behavior Analyst · Gulfport, MS

NPI 1285239590 · NPPES record last updated Dec 3, 2020

Key facts

NPI
1285239590
Entity type
Organization (NPI type 2)
Primary specialty
Behavior Analyst 103K00000X
Legal business name
GULFPORT PREMIER ABA LLC
Practice address
928 Courthouse Rd Unit 3
Gulfport, MS 39507-4110
Phone
(228) 229-8297
NPI assigned
Dec 3, 2020
Organization subpart
No

Authorized official

Name
Gregory Stanford, BCBS, LBA
Title
Co-Owner
Phone
(228) 229-8297

Practitioners 1

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

National Provider Directory

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior Analyst
Group: 193200000X MULTI-SPECIALTY GROUP
103K00000X Yes
Assistant Behavior Analyst
Group: 193200000X MULTI-SPECIALTY GROUP
106E00000X
Behavior Technician
Group: 193200000X MULTI-SPECIALTY GROUP
106S00000X

Addresses

Primary practice location

928 Courthouse Rd Unit 3
Gulfport, MS 39507-4110

Mailing address

928 Courthouse Rd Unit 3
Gulfport, MS 39507-4110
Phone (228) 229-8297

Other providers in Gulfport, MS

All providers in Gulfport, MS · Behavior Analyst in Mississippi

Sources for this page

Verify at the official NPI Registry.