MEDICARE: SELECT CARE ABA MD LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	103K00000X	Behavior Analyst

General Provider Information

NPI Number	:	1003708538
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SELECT CARE ABA MD LLC

Provider Business Mailing Address
First Line	:	6340 SECURITY BOULEVARD
Second Line	:	STE 100 #1449
City	:	BALTIMORE
State	:	MD
Zip	:	21207-5284
Country	:	US
Telephone Number	:	732-503-0379
Fax Number	:	848-288-9217

Provider Business Practice Location Address
First Line	:	6340 SECURITY BOULEVARD
Second Line	:	STE 100 #1449
City	:	BALTIMORE
State	:	MD
Zip	:	21207-5284
Country	:	US
Telephone Number	:	732-503-0379
Fax Number	:	848-288-9217

Authorized Official
Title or Position	:	OFFICE MANAGE
Name	:	TOBY ROTHENBERG
Credential	:
Telephone Number	:	732-503-0379

Provider Enumeration Date	:	07/18/2025
Last Update Date	:	07/23/2025

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Directions to “SELECT CARE ABA MD LLC ” Practice Location

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