Provider Demographics
NPI:1790548709
Name:AUTISM & BEHAVIORAL HEALTH LLC
Entity Type:Organization
Organization Name:AUTISM & BEHAVIORAL HEALTH LLC
Other - Org Name:ROSELLE HEALTH SERVICES LLC
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:ROSE
Authorized Official - Middle Name:
Authorized Official - Last Name:NGATIA
Authorized Official - Suffix:
Authorized Official - Credentials:PMHNP
Authorized Official - Phone:862-215-3417
Mailing Address - Street 1:12 BROWNING CIR
Mailing Address - Street 2:
Mailing Address - City:MIDDLETOWN
Mailing Address - State:DE
Mailing Address - Zip Code:19709-1660
Mailing Address - Country:US
Mailing Address - Phone:862-215-3417
Mailing Address - Fax:
Practice Address - Street 1:12 BROWNING CIR
Practice Address - Street 2:
Practice Address - City:MIDDLETOWN
Practice Address - State:DE
Practice Address - Zip Code:19709-1660
Practice Address - Country:US
Practice Address - Phone:862-215-3417
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-02-01
Last Update Date:2024-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Multi-Specialty
No363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Multi-Specialty