Provider Demographics
NPI:1700230893
Name:HOPE ABA LLC
Entity Type:Organization
Organization Name:HOPE ABA LLC
Other - Org Name:HOPE ABA LLC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CO-FOUNDER
Authorized Official - Prefix:MR
Authorized Official - First Name:TIMOTHY
Authorized Official - Middle Name:E
Authorized Official - Last Name:GANNON
Authorized Official - Suffix:
Authorized Official - Credentials:LABA
Authorized Official - Phone:508-340-9006
Mailing Address - Street 1:86 PLANTATION ST
Mailing Address - Street 2:
Mailing Address - City:WORCESTER
Mailing Address - State:MA
Mailing Address - Zip Code:01604-3024
Mailing Address - Country:US
Mailing Address - Phone:508-340-9006
Mailing Address - Fax:
Practice Address - Street 1:86 PLANTATION ST
Practice Address - Street 2:
Practice Address - City:WORCESTER
Practice Address - State:MA
Practice Address - Zip Code:01604-3024
Practice Address - Country:US
Practice Address - Phone:508-340-9006
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-04-14
Last Update Date:2016-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA0492103K00000X
MA0416103K00000X
MA11314663103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Single Specialty