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General NPI Number Information
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NPI Number | 1073106738
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Entity Type | Organization
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Legal Business Name | SELECT CARE ABA
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Dates
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Enumeration Date | 02/13/2021
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Last Update Date | 03/18/2024
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Provider Practice Location Address
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Address Line | 1771 MADISON AVE STE 6
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City | LAKEWOOD
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State | NJ
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Zip | 08701-1267
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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 | 1771 MADISON AVE STE 6
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City | LAKEWOOD
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State | NJ
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Zip | 08701-1267
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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 | PRESIDENT
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Name | SHMUEL REINER
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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 | 235Z00000X
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Taxonomy Name | Speech-Language Pathologist
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License Number |
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License Number State |
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Taxonomy #2
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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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