MEDICARE: APPLIED BEHAVIORAL ALTERNATIVES, INC.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number State
1	106E00000X	Assistant Behavior Analyst
2	106S00000X	Behavior Technician
3	320900000X	Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
4	103K00000X	Behavior Analyst	CA

General Provider Information

NPI Number	:	1659877298
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	APPLIED BEHAVIORAL ALTERNATIVES, INC.

Provider Business Mailing Address
First Line	:	2001 ELKINS PL
Second Line	:
City	:	ARCADIA
State	:	CA
Zip	:	91006-1518
Country	:	US
Telephone Number	:	818-472-0646
Fax Number	:

Provider Business Practice Location Address
First Line	:	2001 ELKINS PL
Second Line	:
City	:	ARCADIA
State	:	CA
Zip	:	91006-1518
Country	:	US
Telephone Number	:	818-472-0646
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DARREN C LEMON
Credential	:
Telephone Number	:	818-472-0646

Provider Enumeration Date	:	04/03/2018
Last Update Date	:	12/14/2021

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