Provider Demographics
NPI:1720515711
Name:ABACS, LLC
Entity Type:Organization
Organization Name:ABACS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PROGRAM DIRECTOR/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:BRANDON
Authorized Official - Middle Name:
Authorized Official - Last Name:HERSCOVITCH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:617-505-6183
Mailing Address - Street 1:140 WILLARD STREET
Mailing Address - Street 2:APT 22
Mailing Address - City:LOWELL
Mailing Address - State:MA
Mailing Address - Zip Code:01850
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:10 GILL STREET
Practice Address - Street 2:SUITE J
Practice Address - City:WOBURN
Practice Address - State:MA
Practice Address - Zip Code:01801
Practice Address - Country:US
Practice Address - Phone:860-448-5219
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-05-22
Last Update Date:2017-05-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior TechnicianGroup - Single Specialty
No251S00000XAgenciesCommunity/Behavioral HealthGroup - Single Specialty