Provider Demographics
NPI:1174153415
Name:BALANCED ABA
Entity type:Organization
Organization Name:BALANCED ABA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MS
Authorized Official - First Name:SHANDA
Authorized Official - Middle Name:
Authorized Official - Last Name:STRICKLAND
Authorized Official - Suffix:
Authorized Official - Credentials:BCBA, LBA
Authorized Official - Phone:808-845-6080
Mailing Address - Street 1:98-820 MOANALUA RD SPACE 5
Mailing Address - Street 2:PMB 161
Mailing Address - City:AIEA
Mailing Address - State:HI
Mailing Address - Zip Code:96701
Mailing Address - Country:US
Mailing Address - Phone:808-845-6080
Mailing Address - Fax:808-845-6080
Practice Address - Street 1:98-820 MOANALUA RD SPACE 5
Practice Address - Street 2:PMB 161
Practice Address - City:AIEA
Practice Address - State:HI
Practice Address - Zip Code:96701
Practice Address - Country:US
Practice Address - Phone:808-845-6080
Practice Address - Fax:808-845-6081
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-01-24
Last Update Date:2020-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Single Specialty