| Great Expectations Aba Llc | |
|
4950 Broadway Gary IN 46408-4654 | |
| (219) 239-2902 | |
| Not Available |
| Full Name | Great Expectations Aba Llc |
|---|---|
| Speciality | Behavior Analyst |
| Location | 4950 Broadway, Gary, Indiana |
| Authorized Official Name and Position | Keyna Rodgers (MANAGER) |
| Authorized Official Contact | 2192392902 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Great Expectations Aba Llc 4950 Broadway Gary IN 46408-4654 Ph: () - | Great Expectations Aba Llc 4950 Broadway Gary IN 46408-4654 Ph: (219) 239-2902 |
| NPI Number | 1417658444 |
|---|---|
| Provider Enumeration Date | 03/16/2023 |
| Last Update Date | 10/21/2023 |
| Certification Date | 03/23/2023 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1417658444 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103K00000X | Behavior Analyst | (* (Not Available)) | Primary |
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