Lyle Anthony Agoncillo Abapo

Individual provider Active NPI Behavior Technician · Las Vegas, NV

NPI 1982353611 · NPPES record last updated Mar 21, 2022

Key facts

NPI
1982353611
Entity type
Individual (NPI type 1)
Primary specialty
Behavior Technician 106S00000X
Practice address
5940 S Rainbow Blvd
Las Vegas, NV 89118-2506
Phone
(888) 531-8385
NPI assigned
Mar 21, 2022
Sex
Male
Sole proprietor
Yes

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

Practice roles

OrganizationSpecialtyStatusNew patients
Las Vegas Autism Center, LLC Behavior Technician Past Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior Technician
Group: 193400000X SINGLE SPECIALTY GROUP
106S00000X Yes

Addresses

Primary practice location

5940 S Rainbow Blvd
Las Vegas, NV 89118-2506

Mailing address

3921 Diamond Ridge St
Las Vegas, NV 89129-7059

Other providers in Las Vegas, NV

All providers in Las Vegas, NV · Behavior Technician in Nevada

Sources for this page

Verify at the official NPI Registry.