Provider Demographics
NPI:1437969045
Name:SAMBA ABA LLC
Entity type:Organization
Organization Name:SAMBA ABA LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:JOSHUA
Authorized Official - Middle Name:
Authorized Official - Last Name:BAMBERGER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:732-642-1610
Mailing Address - Street 1:250 CEDARBRIDGE AVE STE 290
Mailing Address - Street 2:
Mailing Address - City:LAKEWOOD
Mailing Address - State:NJ
Mailing Address - Zip Code:08701-4236
Mailing Address - Country:US
Mailing Address - Phone:732-642-1610
Mailing Address - Fax:
Practice Address - Street 1:155 TECHNOLOGY PKWY STE 400
Practice Address - Street 2:
Practice Address - City:NORCROSS
Practice Address - State:GA
Practice Address - Zip Code:30092-2969
Practice Address - Country:US
Practice Address - Phone:732-642-1610
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-01-08
Last Update Date:2025-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Single Specialty