Healthcare Provider Details

I. General information

NPI: 1467377762
Provider Name (Legal Business Name): GRAYS ABA THERAPY LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/13/2026
Last Update Date: 08/13/2026
Certification Date: 08/13/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1653 OWEN DR
FAYETTEVILLE NC
28304-3425
US

IV. Provider business mailing address

1653 OWEN DR
FAYETTEVILLE NC
28304-3425
US

V. Phone/Fax

Practice location:
  • Phone: 910-900-4744
  • Fax: 910-370-1556
Mailing address:
  • Phone: 910-900-4744
  • Fax: 910-370-1556

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State

VIII. Authorized Official

Name: TERRANCE GRAY JR.
Title or Position: OWNER
Credential:
Phone: 910-824-8032