Provider Demographics
NPI:1114450400
Name:ABA THERAPY SERVICES LLC
Entity Type:Organization
Organization Name:ABA THERAPY SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:BETH
Authorized Official - Middle Name:L
Authorized Official - Last Name:RAIOLA
Authorized Official - Suffix:
Authorized Official - Credentials:BCBA
Authorized Official - Phone:570-216-3900
Mailing Address - Street 1:6506 RUNNYMEAD LN
Mailing Address - Street 2:
Mailing Address - City:TOBYHANNA
Mailing Address - State:PA
Mailing Address - Zip Code:18466-3252
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:109 PLAZA DR
Practice Address - Street 2:
Practice Address - City:POCONO SUMMIT
Practice Address - State:PA
Practice Address - Zip Code:18346-7844
Practice Address - Country:US
Practice Address - Phone:570-216-3900
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-04-04
Last Update Date:2017-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PABH001527251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health