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General NPI Number Information
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NPI Number | 1003708538
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Entity Type | Organization
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Legal Business Name | SELECT CARE ABA MD LLC
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Dates
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Enumeration Date | 07/18/2025
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Last Update Date | 07/23/2025
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Provider Practice Location Address
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Address Line | 6340 SECURITY BOULEVARD STE 100 #1449
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City | BALTIMORE
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State | MD
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Zip | 21207-5284
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Country | US
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Telephone | 732-503-0379
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Fax | 848-288-9217
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Provider Business Mailing Address
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Address Line | 6340 SECURITY BOULEVARD STE 100 #1449
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City | BALTIMORE
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State | MD
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Zip | 21207-5284
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Country | US
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Telephone | 732-503-0379
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Fax | 848-288-9217
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Authorized Official
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Title or Position | OFFICE MANAGE
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Name | TOBY ROTHENBERG
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Credential |
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Telephone | 732-503-0379
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103K00000X
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Taxonomy Name | Behavior Analyst
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License Number |
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License Number State |
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