Provider Demographics
NPI:1396405957
Name:ABAECARE LLC
Entity Type:Organization
Organization Name:ABAECARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF CENTRALIZED BUSINESS OF
Authorized Official - Prefix:
Authorized Official - First Name:JESSIE
Authorized Official - Middle Name:
Authorized Official - Last Name:FEHRMAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:605-271-2690
Mailing Address - Street 1:1105 W RUSSELL ST
Mailing Address - Street 2:
Mailing Address - City:SIOUX FALLS
Mailing Address - State:SD
Mailing Address - Zip Code:57104-1322
Mailing Address - Country:US
Mailing Address - Phone:605-271-2690
Mailing Address - Fax:
Practice Address - Street 1:856 EXECUTIVE DR
Practice Address - Street 2:
Practice Address - City:OVIEDO
Practice Address - State:FL
Practice Address - Zip Code:32765-7699
Practice Address - Country:US
Practice Address - Phone:605-271-2690
Practice Address - Fax:605-271-3956
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:ABAECARE LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2021-12-23
Last Update Date:2021-12-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Multi-Specialty
No106E00000XBehavioral Health & Social Service ProvidersAssistant Behavior AnalystGroup - Multi-Specialty
No106S00000XBehavioral Health & Social Service ProvidersBehavior TechnicianGroup - Multi-Specialty