=====================================================
General NPI Number Information
=====================================================
NPI Number | 1801597067
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | AURORA ABA SERVICES INC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 03/14/2023
-----------------------------------------------------
Last Update Date | 03/29/2023
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 26368 FERRY CT
-----------------------------------------------------
City | SANTA CLARITA
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 91350-2998
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 833-276-5588
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 26368 FERRY CT
-----------------------------------------------------
City | SANTA CLARITA
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 91350-2998
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 833-276-5588
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | ADMINISTRATIVE SUPERVISOR
-----------------------------------------------------
Name | ELLEN V MONROE
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 818-731-5864
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 103K00000X
-----------------------------------------------------
Taxonomy Name | Behavior Analyst
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------