Provider Demographics
NPI:1285192195
Name:ALLIANCE ABA, LLC
Entity Type:Organization
Organization Name:ALLIANCE ABA, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VICE PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:JENNIFER
Authorized Official - Middle Name:
Authorized Official - Last Name:CHELLIS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:703-229-6121
Mailing Address - Street 1:17932 FRALEY BLVD STE 205
Mailing Address - Street 2:
Mailing Address - City:DUMFRIES
Mailing Address - State:VA
Mailing Address - Zip Code:22026-2456
Mailing Address - Country:US
Mailing Address - Phone:571-606-2428
Mailing Address - Fax:
Practice Address - Street 1:904 PRINCESS ANNE ST STE 204
Practice Address - Street 2:
Practice Address - City:FREDERICKSBURG
Practice Address - State:VA
Practice Address - Zip Code:22401-5801
Practice Address - Country:US
Practice Address - Phone:703-229-4216
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-03-10
Last Update Date:2022-12-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes251S00000XAgenciesCommunity/Behavioral Health
No103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Single Specialty
No106E00000XBehavioral Health & Social Service ProvidersAssistant Behavior AnalystGroup - Single Specialty
No106S00000XBehavioral Health & Social Service ProvidersBehavior TechnicianGroup - Single Specialty