MEDICARE: ALL ABOUT ABA LLC

Medicare Provider Information

Scope of Practice

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

#	Taxonomy Code	Taxonomy
1	103K00000X	Behavior Analyst
2	106S00000X	Behavior Technician
3	251S00000X	Community/Behavioral Health Agency

General Provider Information

NPI Number	:	1932868064
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ALL ABOUT ABA LLC

Provider Business Mailing Address
First Line	:	5868 E 71ST ST STE E-533
Second Line	:
City	:	INDIANAPOLIS
State	:	IN
Zip	:	46220-4075
Country	:	US
Telephone Number	:	844-525-5226
Fax Number	:	844-745-5225

Provider Business Practice Location Address
First Line	:	5868 E 71ST ST STE E-533
Second Line	:
City	:	INDIANAPOLIS
State	:	IN
Zip	:	46220-4075
Country	:	US
Telephone Number	:	844-525-5226
Fax Number	:	844-745-5225

Authorized Official
Title or Position	:	EXECUTIVE MANAGER
Name	:	DAVID KNOLL
Credential	:
Telephone Number	:	347-564-3283

Provider Enumeration Date	:	12/16/2021
Last Update Date	:	12/16/2021

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