Provider Demographics
NPI:1265946453
Name:ABC BEHAVE LLC
Entity type:Organization
Organization Name:ABC BEHAVE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:DIANA
Authorized Official - Middle Name:MARIE
Authorized Official - Last Name:HARDY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:207-570-0081
Mailing Address - Street 1:53 FRONT RIDGE RD
Mailing Address - Street 2:
Mailing Address - City:HOULTON
Mailing Address - State:ME
Mailing Address - Zip Code:04730-3740
Mailing Address - Country:US
Mailing Address - Phone:207-570-0081
Mailing Address - Fax:208-521-5245
Practice Address - Street 1:39 COURT ST STE 202
Practice Address - Street 2:
Practice Address - City:HOULTON
Practice Address - State:ME
Practice Address - Zip Code:04730-2055
Practice Address - Country:US
Practice Address - Phone:207-570-0081
Practice Address - Fax:207-521-5245
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-11-27
Last Update Date:2017-11-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes222Q00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersDevelopmental TherapistGroup - Single Specialty