Provider Demographics
NPI:1760868798
Name:ABA CONCEPTS, INC.
Entity Type:Organization
Organization Name:ABA CONCEPTS, INC.
Other - Org Name:ABATEC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:BETZAIDA
Authorized Official - Middle Name:
Authorized Official - Last Name:FUENTES
Authorized Official - Suffix:
Authorized Official - Credentials:MS, BCBA, LABA
Authorized Official - Phone:954-559-1221
Mailing Address - Street 1:214 MAIN ST.
Mailing Address - Street 2:UNIT 1
Mailing Address - City:MALDEN
Mailing Address - State:MA
Mailing Address - Zip Code:02148-6908
Mailing Address - Country:US
Mailing Address - Phone:617-477-4050
Mailing Address - Fax:617-524-0406
Practice Address - Street 1:214 MAIN ST.
Practice Address - Street 2:UNIT 1
Practice Address - City:MALDEN
Practice Address - State:MA
Practice Address - Zip Code:02148-6908
Practice Address - Country:US
Practice Address - Phone:617-676-5867
Practice Address - Fax:857-244-6299
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-07-31
Last Update Date:2024-05-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA110176564-CMedicaid