Healthcare Provider Details
I. General information
NPI: 1245617042
Provider Name (Legal Business Name): ABA HEALTH SERVICES INC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 04/30/2015
Last Update Date: 04/25/2023
Certification Date: 04/25/2023
Deactivation Date:
Reactivation Date:
III. Provider practice location address
3939 REISTERSTOWN RD SUITE 150
BALTIMORE MD
21215-7601
US
IV. Provider business mailing address
3939 REISTERSTOWN RD STE 105
BALTIMORE MD
21215-7601
US
V. Phone/Fax
- Phone: 410-367-7821
- Fax: 410-367-7823
- Phone: 410-367-7821
- Fax: 410-367-7823
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 261QR0405X |
| Taxonomy | Substance Use Disorder Rehabilitation Clinic/Center |
| License Number | 905477 |
| License Number State | MD |
VIII. Authorized Official
Name: DR.
ALBERT
NJOKU
Title or Position: CEO
Credential: DRPH
Phone: 410-367-7821