| Supportive Care Aba Nc Llc | |
|
104 S White St Ste 150 Wake Forest NC 27587-2773 | |
| (317) 936-1240 | |
| Not Available |
| Full Name | Supportive Care Aba Nc Llc |
|---|---|
| Speciality | Behavior Analyst |
| Location | 104 S White St Ste 150, Wake Forest, North Carolina |
| Authorized Official Name and Position | Ruben Kesherim (MEMBER) |
| Authorized Official Contact | 3179361240 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Supportive Care Aba Nc Llc 104 S White St Ste 150 Wake Forest NC 27587-2773 Ph: () - | Supportive Care Aba Nc Llc 104 S White St Ste 150 Wake Forest NC 27587-2773 Ph: (317) 936-1240 |
| NPI Number | 1457060071 |
|---|---|
| Provider Enumeration Date | 11/22/2022 |
| Last Update Date | 10/17/2023 |
| Certification Date | 10/17/2023 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1457060071 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103K00000X | Behavior Analyst | (* (Not Available)) | Primary |
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Secondary |
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