MEDICARE: ERNEST ABA

Medicare Provider Information

Scope of Practice

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

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	251S00000X	Community/Behavioral Health Agency

General Provider Information

NPI Number	:	1992668834
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ERNEST ABA

Provider Business Mailing Address
First Line	:	3650 E SUMNER AVE
Second Line	:
City	:	INDIANAPOLIS
State	:	IN
Zip	:	46237-1209
Country	:	US
Telephone Number	:	812-205-9219
Fax Number	:

Provider Business Practice Location Address
First Line	:	3650 E SUMNER AVE
Second Line	:
City	:	INDIANAPOLIS
State	:	IN
Zip	:	46237-1209
Country	:	US
Telephone Number	:	812-205-9219
Fax Number	:

Authorized Official
Title or Position	:	CEO
Name	:	MR. JACK GRAVES
Credential	:	MA BCBA
Telephone Number	:	812-205-9219

Provider Enumeration Date	:	12/08/2025
Last Update Date	:	12/08/2025

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