MEDICARE: FAMILY MATTERS ABA

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	251S00000X	Community/Behavioral Health Agency
2	103K00000X	Behavior Analyst

General Provider Information

NPI Number	:	1700464393
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	FAMILY MATTERS ABA

Provider Business Mailing Address
First Line	:	21 ESSEX ST
Second Line	:
City	:	EAST ORANGE
State	:	NJ
Zip	:	07017-1305
Country	:	US
Telephone Number	:	862-800-2569
Fax Number	:	862-205-0148

Provider Business Practice Location Address
First Line	:	21 ESSEX ST
Second Line	:
City	:	EAST ORANGE
State	:	NJ
Zip	:	07017-1305
Country	:	US
Telephone Number	:	862-213-0334
Fax Number	:

Authorized Official
Title or Position	:	OWNER/OPERATIONS MANAGER
Name	:	MR. MPHO TAU SELLO
Credential	:
Telephone Number	:	862-213-0334

Provider Enumeration Date	:	04/01/2021
Last Update Date	:	08/28/2023

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Directions to “FAMILY MATTERS ABA ” Practice Location

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