Healthcare Provider Details

I. General information

NPI: 1033046636
Provider Name (Legal Business Name): ALLRISE ABA MD SRV LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/06/2026
Last Update Date: 05/06/2026
Certification Date: 05/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

306 W REDWOOD ST # 4139
BALTIMORE MD
21201-1708
US

IV. Provider business mailing address

306 W REDWOOD ST # 4139
BALTIMORE MD
21201-1708
US

V. Phone/Fax

Practice location:
  • Phone: 234-255-7473
  • Fax:
Mailing address:
  • Phone: 234-255-7473
  • 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: MRS. CHAVA P ODES
Title or Position: DIRECTOR OF OPERATIONS
Credential:
Phone: 848-287-7756