Provider Demographics
NPI:1417465774
Name:ABA ADAPTIVE SERVICES
Entity Type:Organization
Organization Name:ABA ADAPTIVE SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:TEDI
Authorized Official - Middle Name:RENEE
Authorized Official - Last Name:TEABOUT
Authorized Official - Suffix:
Authorized Official - Credentials:M ED BCBA
Authorized Official - Phone:760-230-1594
Mailing Address - Street 1:2340 CAROL VIEW DR APT 311
Mailing Address - Street 2:
Mailing Address - City:CARDIFF
Mailing Address - State:CA
Mailing Address - Zip Code:92007-2048
Mailing Address - Country:US
Mailing Address - Phone:734-795-5988
Mailing Address - Fax:
Practice Address - Street 1:2340 CAROL VIEW DR APT 311
Practice Address - Street 2:
Practice Address - City:CARDIFF
Practice Address - State:CA
Practice Address - Zip Code:92007-2048
Practice Address - Country:US
Practice Address - Phone:734-795-5988
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-01-19
Last Update Date:2018-01-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO1-17-28184103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Single Specialty