Basic Information
| Provider Information | |||||||||
| NPI: | 1407228836 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | NEW ENGLAND ABA, INC. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 607 NORTH AVE | ||||||||
| Address2: | DOOR 11 FLOOR 2 | ||||||||
| City: | WAKEFIELD | ||||||||
| State: | MA | ||||||||
| PostalCode: | 018801322 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8669264345 | ||||||||
| FaxNumber: | 7815575012 | ||||||||
| Practice Location | |||||||||
| Address1: | 607 NORTH AVE | ||||||||
| Address2: | DOOR 11 FLOOR 2 | ||||||||
| City: | WAKEFIELD | ||||||||
| State: | MA | ||||||||
| PostalCode: | 018801322 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8669264345 | ||||||||
| FaxNumber: | 7815575012 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 10/25/2015 | ||||||||
| LastUpdateDate: | 09/20/2016 | ||||||||
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| AuthorizedOfficialLastName: | SULLIVAN | ||||||||
| AuthorizedOfficialFirstName: | TIMOTHY | ||||||||
| AuthorizedOfficialMiddleName: | COLEMAN | ||||||||
| AuthorizedOfficialTitleorPosition: | FOUNDER AND CEO | ||||||||
| AuthorizedOfficialTelephone: | 7743130981 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialCredential: | BCBA | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 225X00000X | 11981 | CA | N | 193200000X MULTI-SPECIALTY GROUP | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Occupational Therapist | 251S00000X | N | Agencies | Community/Behavioral Health | 103K00000X | 1-11-9321 | CA | Y | 193200000X MULTI-SPECIALTY GROUP | Behavioral Health & Social Service Providers | Behavioral Analyst |
No ID Information.