Healthcare Provider Details

I. General information

NPI: 1548188360
Provider Name (Legal Business Name): EAGLE CARE ABA LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/08/2026
Last Update Date: 07/08/2026
Certification Date: 07/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1200 GORDON DUCKWORTH DR
PIGGOTT AR
72454-1916
US

IV. Provider business mailing address

148 GLEN AVE
LAKEWOOD NJ
08701-3061
US

V. Phone/Fax

Practice location:
  • Phone: 908-670-0558
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number
License Number State

VIII. Authorized Official

Name: STEVEN RIBIAT
Title or Position: MEMBER
Credential:
Phone: 908-670-0558