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General NPI Number Information
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NPI Number | 1467848796
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Entity Type | Organization
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Legal Business Name | CAROLINA ABA SOLUTIONS, LLC
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Dates
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Enumeration Date | 04/14/2015
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Last Update Date | 04/14/2015
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Provider Practice Location Address
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Address Line | 105 SWANHAVEN DR
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City | LEXINGTON
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State | SC
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Zip | 29073-6996
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Country | US
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Telephone | 803-984-0335
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Fax |
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Provider Business Mailing Address
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Address Line | 105 SWANHAVEN DR
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City | LEXINGTON
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State | SC
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Zip | 29073-6996
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Country | US
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Telephone | 803-984-0335
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Fax |
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Authorized Official
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Title or Position | OWNER/ CLINICAL DIRECTOR
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Name | MRS. COURTNEY M THAMES
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Credential | BCBA
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Telephone | 803-984-0335
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number | 150312-0036
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License Number State | SC
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