Provider Demographics
NPI:1750675591
Name:ABA PROFESSIONAL SERVICES, LLC
Entity Type:Organization
Organization Name:ABA PROFESSIONAL SERVICES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEMBER
Authorized Official - Prefix:MR
Authorized Official - First Name:JEFFREY
Authorized Official - Middle Name:CHARLES
Authorized Official - Last Name:ENZINNA
Authorized Official - Suffix:
Authorized Official - Credentials:MS
Authorized Official - Phone:281-232-0453
Mailing Address - Street 1:1710 PITTS RD
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:TX
Mailing Address - Zip Code:77406-1347
Mailing Address - Country:US
Mailing Address - Phone:281-232-0453
Mailing Address - Fax:
Practice Address - Street 1:1710 PITTS RD
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:TX
Practice Address - Zip Code:77406-1347
Practice Address - Country:US
Practice Address - Phone:281-232-0453
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-06-08
Last Update Date:2011-06-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Multi-Specialty