Provider Demographics
NPI:1821871146
Name:ABOVE AND BEYOND ABA UT LLC
Entity Type:Organization
Organization Name:ABOVE AND BEYOND ABA UT LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:MATT
Authorized Official - Middle Name:
Authorized Official - Last Name:ROKOWSKY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:732-806-0091
Mailing Address - Street 1:311 BOULEVARD OF AMERICAS STE 304
Mailing Address - Street 2:
Mailing Address - City:LAKEWOOD
Mailing Address - State:NJ
Mailing Address - Zip Code:08701-4788
Mailing Address - Country:US
Mailing Address - Phone:732-806-0091
Mailing Address - Fax:732-813-8001
Practice Address - Street 1:7533 S CENTER VIEW CT # 4126
Practice Address - Street 2:
Practice Address - City:WEST JORDAN
Practice Address - State:UT
Practice Address - Zip Code:84084-5526
Practice Address - Country:US
Practice Address - Phone:732-806-0091
Practice Address - Fax:732-813-8001
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:ABOVE AND BEYOND ABA CORPORATE LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2023-08-18
Last Update Date:2023-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Multi-Specialty
No106E00000XBehavioral Health & Social Service ProvidersAssistant Behavior AnalystGroup - Multi-Specialty
No106S00000XBehavioral Health & Social Service ProvidersBehavior TechnicianGroup - Multi-Specialty