Provider Demographics
NPI:1285070946
Name:FIVE STAR ABA, INC.
Entity type:Organization
Organization Name:FIVE STAR ABA, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:
Authorized Official - Last Name:WARNER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:877-316-4088
Mailing Address - Street 1:543 CARTWRIGHT WAY
Mailing Address - Street 2:
Mailing Address - City:GREENBRIER
Mailing Address - State:TN
Mailing Address - Zip Code:37073-3516
Mailing Address - Country:US
Mailing Address - Phone:877-316-4088
Mailing Address - Fax:877-875-2991
Practice Address - Street 1:543 CARTWRIGHT WAY
Practice Address - Street 2:
Practice Address - City:GREENBRIER
Practice Address - State:TN
Practice Address - Zip Code:37073-3516
Practice Address - Country:US
Practice Address - Phone:877-316-4088
Practice Address - Fax:877-875-2991
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-05-21
Last Update Date:2013-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health