Provider Demographics
NPI:1003248287
Name:ABA DEPOT LLC
Entity Type:Organization
Organization Name:ABA DEPOT LLC
Other - Org Name:EDSOLUTIONS LLC
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:SPEARS
Authorized Official - Middle Name:
Authorized Official - Last Name:BECKHAM
Authorized Official - Suffix:
Authorized Official - Credentials:BCBA
Authorized Official - Phone:843-799-0076
Mailing Address - Street 1:3444 LAKESHORE DRIVE
Mailing Address - Street 2:
Mailing Address - City:FLORENCE
Mailing Address - State:SC
Mailing Address - Zip Code:29501
Mailing Address - Country:US
Mailing Address - Phone:843-799-0076
Mailing Address - Fax:800-557-0208
Practice Address - Street 1:800 E CHEVES ST STE 280
Practice Address - Street 2:
Practice Address - City:FLORENCE
Practice Address - State:SC
Practice Address - Zip Code:29506-2652
Practice Address - Country:US
Practice Address - Phone:843-799-0076
Practice Address - Fax:800-557-0208
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-07-30
Last Update Date:2024-04-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
103K00000X
SCBACB # 1-11-8879251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes251S00000XAgenciesCommunity/Behavioral Health
No103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Multi-Specialty