1598583015 NPI number — CHILDRENS SPECIALIZED HOSPITAL ABA II, LLC

Table of content: (NPI 1598583015)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1598583015 NPI number — CHILDRENS SPECIALIZED HOSPITAL ABA II, LLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
CHILDRENS SPECIALIZED HOSPITAL ABA II, 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:
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:
1598583015
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
02/06/2025
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
175 BELGROVE DR
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
KEARNY
Provider Business Mailing Address State Name:
NJ
Provider Business Mailing Address Postal Code:
07032-1507
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
216-216-9500
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
500 REDLAND CT STE 102
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
OWINGS MILLS
Provider Business Practice Location Address State Name:
MD
Provider Business Practice Location Address Postal Code:
21117-3265
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
844-854-2583
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
10/02/2024

Additional Information

Authorized Official

Authorized Official Last Name:
SUSSMAN
Authorized Official First Name:
DOVID
Authorized Official Middle Name:
Authorized Official Title or Position:
MANAGING DIRECTOR
Authorized Official Telephone Number:
216-216-9500

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)





Copyright © 2007-2025 www.npivalidator.com