Provider Demographics
NPI:1356212211
Name:OUT OF THE BOX ABA
Entity type:Organization
Organization Name:OUT OF THE BOX ABA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CREDENTIALING SPECIALIST
Authorized Official - Prefix:
Authorized Official - First Name:JAI
Authorized Official - Middle Name:
Authorized Official - Last Name:BRAMBHATT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:904-730-1585
Mailing Address - Street 1:99 DERBY ST STE 200
Mailing Address - Street 2:
Mailing Address - City:HINGHAM
Mailing Address - State:MA
Mailing Address - Zip Code:02043-4216
Mailing Address - Country:US
Mailing Address - Phone:508-455-5683
Mailing Address - Fax:774-307-9842
Practice Address - Street 1:99 DERBY ST STE 200
Practice Address - Street 2:
Practice Address - City:HINGHAM
Practice Address - State:MA
Practice Address - Zip Code:02043-4216
Practice Address - Country:US
Practice Address - Phone:508-455-5683
Practice Address - Fax:774-307-9842
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-09-15
Last Update Date:2025-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Single Specialty