Healthcare Provider Details
I. General information
NPI: 1447483045
Provider Name (Legal Business Name): ABA2DAY BEHAVIOR SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 08/29/2009
Last Update Date: 08/29/2009
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
340 MEDIA STATION RD APT A-208
MEDIA PA
19063-4754
US
IV. Provider business mailing address
340 MEDIA STATION RD APT A-208
MEDIA PA
19063-4754
US
V. Phone/Fax
- Phone: 561-213-3738
- Fax:
- Phone: 561-213-3738
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 251S00000X |
| Taxonomy | Community/Behavioral Health Agency |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 252Y00000X |
| Taxonomy | Early Intervention Provider Agency |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
ALONNA
MARCUS
Title or Position: OWNER/BCBA
Credential: M.S., BCBA
Phone: 561-213-3738