Provider Demographics
NPI:1609514728
Name:ABAZING, LLC
Entity Type:Organization
Organization Name:ABAZING, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BCBA
Authorized Official - Prefix:
Authorized Official - First Name:DELONTE
Authorized Official - Middle Name:TREQUAN
Authorized Official - Last Name:JONES
Authorized Official - Suffix:
Authorized Official - Credentials:BCBA
Authorized Official - Phone:434-610-9856
Mailing Address - Street 1:149 KATHANN DR # B
Mailing Address - Street 2:
Mailing Address - City:HAMPTON
Mailing Address - State:VA
Mailing Address - Zip Code:23605-1254
Mailing Address - Country:US
Mailing Address - Phone:434-610-9856
Mailing Address - Fax:
Practice Address - Street 1:149 KATHANN DR # B
Practice Address - Street 2:
Practice Address - City:HAMPTON
Practice Address - State:VA
Practice Address - Zip Code:23605-1254
Practice Address - Country:US
Practice Address - Phone:434-610-9856
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-05-27
Last Update Date:2022-05-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes252Y00000XAgenciesEarly Intervention Provider Agency
No251E00000XAgenciesHome Health
No251S00000XAgenciesCommunity/Behavioral Health
No261Q00000XAmbulatory Health Care FacilitiesClinic/Center