Healthcare Provider Details

I. General information

NPI: 1871006890
Provider Name (Legal Business Name): AROUND THE CLOCK 4 ABA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/13/2017
Last Update Date: 01/09/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2100 N SEPULVEDA BLVD
MANHATTAN BEACH CA
90266-2948
US

IV. Provider business mailing address

6737 DESOTO AVE 122
CANOGA PARK CA
91303
US

V. Phone/Fax

Practice location:
  • Phone: 818-312-5337
  • Fax: 424-400-5650
Mailing address:
  • Phone:
  • Fax: 424-400-5650

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code106E00000X
TaxonomyAssistant Behavior Analyst
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code385H00000X
TaxonomyRespite Care
License Number
License Number State

VIII. Authorized Official

Name: CHRISTINE MARY LANG
Title or Position: PARTNER
Credential:
Phone: 818-312-5337