MEDICARE: ABASI LLC

Medicare Provider Information

Scope of Practice

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

#	Taxonomy Code	Taxonomy
1	106E00000X	Assistant Behavior Analyst
2	106S00000X	Behavior Technician
3	103K00000X	Behavior Analyst

General Provider Information

NPI Number	:	1336912427
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ABASI LLC

Provider Business Mailing Address
First Line	:	66 MILL CREEK DR
Second Line	:
City	:	YOUNGSTOWN
State	:	OH
Zip	:	44512-1549
Country	:	US
Telephone Number	:	561-279-3852
Fax Number	:	561-437-8116

Provider Business Practice Location Address
First Line	:	66 MILL CREEK DR
Second Line	:
City	:	YOUNGSTOWN
State	:	OH
Zip	:	44512-1549
Country	:	US
Telephone Number	:	561-279-3852
Fax Number	:	561-437-8116

Authorized Official
Title or Position	:	FOUNDER/OWNER
Name	:	JUSTYN HARVEY
Credential	:	BCBA
Telephone Number	:	904-415-4661

Provider Enumeration Date	:	11/01/2023
Last Update Date	:	10/18/2024

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Directions to “ABASI LLC ” Practice Location

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