Healthcare Provider Details

I. General information

NPI: 1437903408
Provider Name (Legal Business Name): ESCALATE ABA INDIANA LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/15/2024
Last Update Date: 04/15/2024
Certification Date: 04/15/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

838 N DELAWARE ST STE 9
INDIANAPOLIS IN
46204-1127
US

IV. Provider business mailing address

838 N DELAWARE ST STE 9
INDIANAPOLIS IN
46204-1127
US

V. Phone/Fax

Practice location:
  • Phone: 718-705-5225
  • Fax:
Mailing address:
  • Phone: 718-705-5225
  • 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: BERNARD PILLER
Title or Position: OWNER
Credential:
Phone: 718-705-5225