Provider Demographics
NPI:1912679556
Name:PREFERRED ABA SERVICES LLC
Entity Type:Organization
Organization Name:PREFERRED ABA SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:RAJIV
Authorized Official - Middle Name:L
Authorized Official - Last Name:SRIVASTAVA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:706-905-9955
Mailing Address - Street 1:3700 S RAILROAD ST STE A
Mailing Address - Street 2:
Mailing Address - City:PHENIX CITY
Mailing Address - State:AL
Mailing Address - Zip Code:36867-2994
Mailing Address - Country:US
Mailing Address - Phone:706-905-9955
Mailing Address - Fax:334-664-0463
Practice Address - Street 1:3700 S RAILROAD ST STE A
Practice Address - Street 2:
Practice Address - City:PHENIX CITY
Practice Address - State:AL
Practice Address - Zip Code:36867-2994
Practice Address - Country:US
Practice Address - Phone:706-905-9955
Practice Address - Fax:334-664-0463
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-10-01
Last Update Date:2021-10-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Single Specialty