1801428578 NPI number — EVERYTHING ABA BEHAVIOR SUPPORT & CONSULTING

Table of content: (NPI 1801428578)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1801428578 NPI number — EVERYTHING ABA BEHAVIOR SUPPORT & CONSULTING

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
EVERYTHING ABA BEHAVIOR SUPPORT & CONSULTING
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:
1801428578
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
02/10/2020
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
625 BAKERS BRIDGE AVE STE 105-21
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
FRANKLIN
Provider Business Mailing Address State Name:
TN
Provider Business Mailing Address Postal Code:
37067-1613
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
615-631-8008
Provider Business Mailing Address Fax Number:
615-503-8411

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
754 FRENCH RIVER RD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
NOLENSVILLE
Provider Business Practice Location Address State Name:
TN
Provider Business Practice Location Address Postal Code:
37135-9636
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
615-631-8008
Provider Business Practice Location Address Fax Number:
615-503-8411
Provider Enumeration Date:
02/10/2020

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
MUCHUKOT
Authorized Official First Name:
LORETTA
Authorized Official Middle Name:
ANNETTE
Authorized Official Title or Position:
OWNER
Authorized Official Telephone Number:
615-631-8008

Provider Taxonomy Codes

  • Taxonomy code: 103K00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 106E00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 106S00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

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

  • Identifier: 1093965667 . This is a "NPI" identifier . This identifiers is of the category "OTHER".
  • Identifier: 1523796 , issued by the state of ( TN ) . This identifiers is of the category "MEDICAID".
  • Identifier: 1639311376 . This is a "NPI" identifier , issued by the state of ( TN ) . This identifiers is of the category "OTHER".