Healthcare Provider Details

I. General information

NPI: 1164237475
Provider Name (Legal Business Name): HEART & HOME ABA, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/12/2025
Last Update Date: 02/13/2025
Certification Date: 02/13/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12842 DRUMDOW LN
FISHERS IN
46037-5607
US

IV. Provider business mailing address

12842 DRUMDOW LN
FISHERS IN
46037-5607
US

V. Phone/Fax

Practice location:
  • Phone: 386-295-5463
  • Fax:
Mailing address:
  • Phone: 386-295-5463
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number
License Number State

VIII. Authorized Official

Name: MAURICE MACEWEN
Title or Position: CEO
Credential:
Phone: 386-295-5463