Provider Demographics
NPI:1750108791
Name:EZCARE ABA LLC
Entity type:Organization
Organization Name:EZCARE ABA LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:EZRA
Authorized Official - Middle Name:
Authorized Official - Last Name:SHULMAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:732-552-7481
Mailing Address - Street 1:21 KING DAVID DR
Mailing Address - Street 2:
Mailing Address - City:LAKEWOOD
Mailing Address - State:NJ
Mailing Address - Zip Code:08701-4666
Mailing Address - Country:US
Mailing Address - Phone:732-552-7481
Mailing Address - Fax:
Practice Address - Street 1:2807 N PARHAM RD STE 320
Practice Address - Street 2:
Practice Address - City:HENRICO
Practice Address - State:VA
Practice Address - Zip Code:23294-4458
Practice Address - Country:US
Practice Address - Phone:732-552-7481
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-09-23
Last Update Date:2024-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Single Specialty