Provider Demographics
NPI:1518626837
Name:TOTAL CARE ABA IN LLC
Entity Type:Organization
Organization Name:TOTAL CARE ABA IN LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:RUBEN
Authorized Official - Middle Name:
Authorized Official - Last Name:KESHERIM
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:404-400-5004
Mailing Address - Street 1:120 E MARKET ST STE 1267
Mailing Address - Street 2:
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46204-3250
Mailing Address - Country:US
Mailing Address - Phone:404-400-5004
Mailing Address - Fax:404-400-5003
Practice Address - Street 1:120 E MARKET ST STE 1267
Practice Address - Street 2:
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46204-3250
Practice Address - Country:US
Practice Address - Phone:404-400-5004
Practice Address - Fax:404-400-5003
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-12-14
Last Update Date:2022-02-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Multi-Specialty