Provider Demographics
NPI:1104598788
Name:ABOVE AND BEYOND ABA NM LLC
Entity type:Organization
Organization Name:ABOVE AND BEYOND ABA NM LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:MATT
Authorized Official - Middle Name:
Authorized Official - Last Name:ROKOWKSY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:402-252-1363
Mailing Address - Street 1:185 ROUTE 70 STE 302
Mailing Address - Street 2:
Mailing Address - City:TOMS RIVER
Mailing Address - State:NJ
Mailing Address - Zip Code:08755-0936
Mailing Address - Country:US
Mailing Address - Phone:732-806-0091
Mailing Address - Fax:732-813-8001
Practice Address - Street 1:500 MARQUETTE AVE NW STE 1200
Practice Address - Street 2:
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87102-5312
Practice Address - Country:US
Practice Address - Phone:732-806-0091
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:ABOVE AND BEYOND ABA CORPORATE LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2021-10-01
Last Update Date:2024-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Multi-Specialty
No106S00000XBehavioral Health & Social Service ProvidersBehavior TechnicianGroup - Multi-Specialty