1023631298 NPI number — ABA SOLUTIONS, LLC

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1023631298 NPI number — ABA SOLUTIONS, LLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
ABA SOLUTIONS, LLC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
6
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1023631298
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
05/01/2024
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
2929 COACH CT
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
NORMAN
Provider Business Mailing Address State Name:
OK
Provider Business Mailing Address Postal Code:
73071-5505
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
580-721-0318
Provider Business Mailing Address Fax Number:
405-561-4137

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1503 ALAMEDA ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
NORMAN
Provider Business Practice Location Address State Name:
OK
Provider Business Practice Location Address Postal Code:
73071-3012
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
405-355-9433
Provider Business Practice Location Address Fax Number:
405-561-4137
Provider Enumeration Date:
05/22/2020

Additional Information

Authorized Official

Authorized Official Last Name:
MARTIN
Authorized Official First Name:
JULIA
Authorized Official Middle Name:
Authorized Official Title or Position:
OWNER/BCBA SUPERVISOR
Authorized Official Telephone Number:
580-721-0318

Provider Taxonomy Codes

  • Taxonomy code: 103K00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 200849880A , issued by the state of ( OK ) . This identifiers is of the category "MEDICAID".




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