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NPI Code Detail

MEDICARE: ABAECARE, LLC

MEDICARE: ABAECARE, 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
1106E00000XAssistant Behavior Analyst
2106S00000XBehavior Technician
3103K00000XBehavior Analyst

General Provider Information

NPI Number : 1790548139
Entity Type Code : Organization
Provider Name (Legal Business Name) : ABAECARE, LLC
Provider Business Mailing Address
First Line : 1105 W RUSSELL ST
Second Line :
City : SIOUX FALLS
State : SD
Zip : 57104-1322
Country : US
Telephone Number : 605-271-2690
Fax Number :
Provider Business Practice Location Address
First Line : 1021 HAMPSHIRE LN
Second Line :
City : RICHARDSON
State : TX
Zip : 75080-5143
Country : US
Telephone Number : 605-271-2690
Fax Number :
Authorized Official
Title or Position : DIRECTOR OF CENTRALIZED BUSINESS OF
Name : JESSIE FEHRMAN
Credential :
Telephone Number : 605-271-2690
Provider Enumeration Date : 01/30/2024
Last Update Date : 01/30/2024

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