MEDICARE: ABC INTERVENTION SERVICES, INC.

Medicare Provider Information

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

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	251C00000X	Developmentally Disabled Services Day Training Agency	1-04-1898	FL

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

NPI Number	:	1891764817
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ABC INTERVENTION SERVICES, INC.

Provider Business Mailing Address
First Line	:	2925 70TH PL
Second Line	:
City	:	VERO BEACH
State	:	FL
Zip	:	32967-5755
Country	:	US
Telephone Number	:	772-473-3460
Fax Number	:	772-770-5846

Provider Business Practice Location Address
First Line	:	2925 70TH PL
Second Line	:
City	:	VERO BEACH
State	:	FL
Zip	:	32967-5755
Country	:	US
Telephone Number	:	772-473-3460
Fax Number	:	772-770-5846

Authorized Official
Title or Position	:	PRESIDENT / BEHAVIOR ANALSYST
Name	:	DAWNE NOELKE D'ALBORA
Credential	:	B.C.B.A.
Telephone Number	:	772-473-3460

Provider Enumeration Date	:	03/14/2006
Last Update Date	:	08/15/2016

5755 38TH ST
VERO BEACH, FL
32966-1805

Practice Phone: 772-404-9353
Practice Fax:

5755 20TH ST
VERO BEACH, FL
32966-4636