MEDICARE: ABOVE AND BEYOND ABA UT 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	:	1821871146
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ABOVE AND BEYOND ABA UT LLC

Provider Business Mailing Address
First Line	:	185 ROUTE 70 STE 302
Second Line	:
City	:	TOMS RIVER
State	:	NJ
Zip	:	08755-0936
Country	:	US
Telephone Number	:	732-806-0091
Fax Number	:	732-813-8001

Provider Business Practice Location Address
First Line	:	7533 S CENTER VIEW CT # 4126
Second Line	:
City	:	WEST JORDAN
State	:	UT
Zip	:	84084-5526
Country	:	US
Telephone Number	:	732-806-0091
Fax Number	:	732-813-8001

Authorized Official
Title or Position	:	MANAGER
Name	:	MATT ROKOWSKY
Credential	:
Telephone Number	:	732-806-0091

Provider Enumeration Date	:	08/18/2023
Last Update Date	:	09/09/2024

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Directions to “ABOVE AND BEYOND ABA UT LLC ” Practice Location

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