Healthcare Provider Details
I. General information
NPI: 1023948205
Provider Name (Legal Business Name): ABA GRATEFUL CARE MD
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 05/20/2026
Last Update Date: 05/20/2026
Certification Date: 05/20/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
9505 REISTERSTOWN RD STE 2NW
OWINGS MILLS MD
21117-4451
US
IV. Provider business mailing address
10770 COLUMBIA PIKE SUITE 300 #1269
SILVER SPRING MD
20901
US
V. Phone/Fax
- Phone: 317-572-5315
- Fax:
- Phone:
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 106S00000X |
| Taxonomy | Behavior Technician |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 103K00000X |
| Taxonomy | Behavior Analyst |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
REUVEN
LEVOVITZ
Title or Position: CEO
Credential:
Phone: 317-572-5315