Provider Demographics
NPI:1245617042
Name:ABA HEALTH SERVICES INC
Entity Type:Organization
Organization Name:ABA HEALTH SERVICES INC
Other - Org Name:ABA HEALTH SERVICES INC
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:ALBERT
Authorized Official - Middle Name:
Authorized Official - Last Name:NJOKU
Authorized Official - Suffix:
Authorized Official - Credentials:DRPH
Authorized Official - Phone:410-367-7821
Mailing Address - Street 1:3939 REISTERSTOWN RD STE 105
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21215-7601
Mailing Address - Country:US
Mailing Address - Phone:410-367-7821
Mailing Address - Fax:410-367-7823
Practice Address - Street 1:3939 REISTERSTOWN RD
Practice Address - Street 2:SUITE 150
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21215-7601
Practice Address - Country:US
Practice Address - Phone:410-367-7821
Practice Address - Fax:410-367-7823
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-04-30
Last Update Date:2023-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD905477261QR0405X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0405XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation, Substance Use Disorder
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD400448500Medicaid
MD400407800Medicaid
MD400448500Medicaid
MD400407800Medicaid