Provider Demographics
NPI:1114771672
Name:AVENUES ABA NC LLC
Entity Type:Organization
Organization Name:AVENUES ABA NC LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:COO
Authorized Official - Prefix:
Authorized Official - First Name:NAFTALI
Authorized Official - Middle Name:
Authorized Official - Last Name:FIREMAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:732-569-4524
Mailing Address - Street 1:801 MONTGOMERY AVE
Mailing Address - Street 2:
Mailing Address - City:TOMS RIVER
Mailing Address - State:NJ
Mailing Address - Zip Code:08757-1137
Mailing Address - Country:US
Mailing Address - Phone:732-569-4524
Mailing Address - Fax:
Practice Address - Street 1:5960 FAIRVIEW RD STE 400
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28210-3119
Practice Address - Country:US
Practice Address - Phone:704-269-8525
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-04-12
Last Update Date:2024-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Multi-Specialty