Provider Demographics
NPI:1033650312
Name:ANCHORABA LLC
Entity Type:Organization
Organization Name:ANCHORABA LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MORGAN
Authorized Official - Middle Name:ELAINE
Authorized Official - Last Name:CATES
Authorized Official - Suffix:
Authorized Official - Credentials:BCBA
Authorized Official - Phone:410-271-1380
Mailing Address - Street 1:28 DAISY HILL RD
Mailing Address - Street 2:
Mailing Address - City:OAKDALE
Mailing Address - State:CT
Mailing Address - Zip Code:06370-1753
Mailing Address - Country:US
Mailing Address - Phone:410-271-1380
Mailing Address - Fax:
Practice Address - Street 1:28 DAISY HILL RD
Practice Address - Street 2:
Practice Address - City:OAKDALE
Practice Address - State:CT
Practice Address - Zip Code:06370-1753
Practice Address - Country:US
Practice Address - Phone:410-271-1380
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-03-20
Last Update Date:2017-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
16-22296103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Single Specialty