Healthcare Provider Details

I. General information

NPI: 1437070513
Provider Name (Legal Business Name): ABA HEALTH, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/23/2026
Last Update Date: 07/23/2026
Certification Date: 07/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

486 ARNAZ DR
LOS ANGELES CA
90048-3913
US

IV. Provider business mailing address

486 ARNAZ DR
LOS ANGELES CA
90048-3913
US

V. Phone/Fax

Practice location:
  • Phone: 630-319-0778
  • Fax:
Mailing address:
  • Phone: 630-319-0778
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number StateNULL

VIII. Authorized Official

Name: MR. BENNETT BLAKEMAN
Title or Position: CO-FOUNDER
Credential:
Phone: 630-319-0778