Provider Demographics
NPI:1215596119
Name:NEIGHBORHOOD ABA AND BEHAVIORAL HEALTH SERVICES, LLC
Entity Type:Organization
Organization Name:NEIGHBORHOOD ABA AND BEHAVIORAL HEALTH SERVICES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/CEO
Authorized Official - Prefix:
Authorized Official - First Name:CYNTHIA
Authorized Official - Middle Name:IRENE
Authorized Official - Last Name:WALL
Authorized Official - Suffix:
Authorized Official - Credentials:BCBA, LABA
Authorized Official - Phone:508-463-8290
Mailing Address - Street 1:47 JUNIPER RD UNIT A2
Mailing Address - Street 2:
Mailing Address - City:NORTH ATTLEBORO
Mailing Address - State:MA
Mailing Address - Zip Code:02760-6113
Mailing Address - Country:US
Mailing Address - Phone:508-463-8290
Mailing Address - Fax:
Practice Address - Street 1:47 JUNIPER RD UNIT A2
Practice Address - Street 2:
Practice Address - City:NORTH ATTLEBORO
Practice Address - State:MA
Practice Address - Zip Code:02760-6113
Practice Address - Country:US
Practice Address - Phone:508-463-8290
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-06-13
Last Update Date:2019-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Single Specialty