Healthcare Provider Details

I. General information

NPI: 1871288019
Provider Name (Legal Business Name): SUNSET ABA, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/05/2023
Last Update Date: 04/05/2023
Certification Date: 04/04/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3600 ROUTE 66 STE 150
NEPTUNE NJ
07753-2645
US

IV. Provider business mailing address

3600 ROUTE 66 STE 150
NEPTUNE NJ
07753-2645
US

V. Phone/Fax

Practice location:
  • Phone: 301-580-8764
  • Fax:
Mailing address:
  • Phone: 301-580-8764
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code106E00000X
TaxonomyAssistant Behavior Analyst
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number
License Number State

VIII. Authorized Official

Name: MELISSA FOSTER
Title or Position: CEO
Credential: M.S., BCBA
Phone: 301-580-8764