Provider Demographics
NPI:1851714349
Name:FOCUSED ABA SERVICES LLC
Entity Type:Organization
Organization Name:FOCUSED ABA SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:JENNIFER
Authorized Official - Middle Name:MARIE
Authorized Official - Last Name:REILLY
Authorized Official - Suffix:
Authorized Official - Credentials:BCBA
Authorized Official - Phone:970-623-6369
Mailing Address - Street 1:3589 HIGHWAY 41A S
Mailing Address - Street 2:
Mailing Address - City:CLARKSVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37043-6805
Mailing Address - Country:US
Mailing Address - Phone:970-623-6369
Mailing Address - Fax:855-850-8162
Practice Address - Street 1:3589 HIGHWAY 41A S
Practice Address - Street 2:
Practice Address - City:CLARKSVILLE
Practice Address - State:TN
Practice Address - Zip Code:37043-6805
Practice Address - Country:US
Practice Address - Phone:970-623-6369
Practice Address - Fax:855-850-8162
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-02-04
Last Update Date:2014-02-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN1-11-9563251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
TNQ001259Medicaid