Provider Demographics
NPI:1407661721
Name:MEMOREABLE ABA LLC
Entity type:Organization
Organization Name:MEMOREABLE ABA LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:HR
Authorized Official - Prefix:
Authorized Official - First Name:MAVELYN
Authorized Official - Middle Name:
Authorized Official - Last Name:MILLARD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:239-396-0181
Mailing Address - Street 1:2725 INLET COVE LN W
Mailing Address - Street 2:
Mailing Address - City:NAPLES
Mailing Address - State:FL
Mailing Address - Zip Code:34120-7548
Mailing Address - Country:US
Mailing Address - Phone:239-396-0181
Mailing Address - Fax:800-961-3367
Practice Address - Street 1:27911 WATERFORD EXECUTIVE CENTRE
Practice Address - Street 2:
Practice Address - City:BONITA SPRINGS
Practice Address - State:FL
Practice Address - Zip Code:34135-3413
Practice Address - Country:US
Practice Address - Phone:239-396-0181
Practice Address - Fax:800-961-3367
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-02-12
Last Update Date:2025-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Single Specialty
No251E00000XAgenciesHome Health
No251S00000XAgenciesCommunity/Behavioral Health