Provider Demographics
NPI:1508578857
Name:COLORES ABA
Entity Type:Organization
Organization Name:COLORES ABA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:PAULINE
Authorized Official - Middle Name:CRYSTAL
Authorized Official - Last Name:BROWN
Authorized Official - Suffix:
Authorized Official - Credentials:MA, BCBA, LBA
Authorized Official - Phone:480-865-9506
Mailing Address - Street 1:13000 N 103RD AVE STE 79
Mailing Address - Street 2:
Mailing Address - City:SUN CITY
Mailing Address - State:AZ
Mailing Address - Zip Code:85351-3060
Mailing Address - Country:US
Mailing Address - Phone:602-772-7818
Mailing Address - Fax:
Practice Address - Street 1:13000 N 103RD AVE STE 79
Practice Address - Street 2:
Practice Address - City:SUN CITY
Practice Address - State:AZ
Practice Address - Zip Code:85351-3060
Practice Address - Country:US
Practice Address - Phone:602-772-7818
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-12-19
Last Update Date:2023-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Single Specialty