Provider Demographics
NPI:1285453043
Name:HUMANAS ABA THERAPY, LLC
Entity type:Organization
Organization Name:HUMANAS ABA THERAPY, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:CARL
Authorized Official - Middle Name:
Authorized Official - Last Name:JONE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:919-520-3655
Mailing Address - Street 1:302 HOLLY BLOSSOM DR
Mailing Address - Street 2:
Mailing Address - City:DURHAM
Mailing Address - State:NC
Mailing Address - Zip Code:27703-9466
Mailing Address - Country:US
Mailing Address - Phone:919-520-3655
Mailing Address - Fax:
Practice Address - Street 1:302 HOLLY BLOSSOM DR
Practice Address - Street 2:
Practice Address - City:DURHAM
Practice Address - State:NC
Practice Address - Zip Code:27703-9466
Practice Address - Country:US
Practice Address - Phone:919-520-3655
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-10-08
Last Update Date:2024-10-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center