Healthcare Provider Details

I. General information

NPI: 1558171488
Provider Name (Legal Business Name): ABA DAY BY DAY LLC- RESPITE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/13/2025
Last Update Date: 01/13/2025
Certification Date: 01/13/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

188 JEFFERSON ST # 1150
NEWARK NJ
07105-1622
US

IV. Provider business mailing address

188 JEFFERSON ST # 1150
NEWARK NJ
07105-1622
US

V. Phone/Fax

Practice location:
  • Phone: 973-432-4894
  • Fax: 973-869-2483
Mailing address:
  • Phone: 973-432-4894
  • Fax: 973-869-2483

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code385H00000X
TaxonomyRespite Care
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code385HR2050X
TaxonomyRespite Care Camp
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code385HR2055X
TaxonomyChild Mental Illness Respite Care
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code385HR2060X
TaxonomyChild Intellectual and/or Developmental Disabilities Respite Care
License Number
License Number State
# 5
Primary TaxonomyN
Taxonomy Code385HR2065X
TaxonomyChild Physical Disabilities Respite Care
License Number
License Number State

VIII. Authorized Official

Name: MS. RASHAMELLA T WALCOTT
Title or Position: DIRECTOR
Credential: BCBA
Phone: 973-432-4894