Provider Demographics
NPI:1568289064
Name:BEHAVIORAL COACH ABA CORP
Entity type:Organization
Organization Name:BEHAVIORAL COACH ABA CORP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF EXECUTIVE OFFICER
Authorized Official - Prefix:MR
Authorized Official - First Name:PATRICK
Authorized Official - Middle Name:
Authorized Official - Last Name:FLEURY
Authorized Official - Suffix:
Authorized Official - Credentials:MED
Authorized Official - Phone:215-459-0294
Mailing Address - Street 1:1657 THE FAIRWAY STE 168
Mailing Address - Street 2:
Mailing Address - City:JENKINTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:19046-1423
Mailing Address - Country:US
Mailing Address - Phone:215-459-0294
Mailing Address - Fax:
Practice Address - Street 1:1800 BEECH AVE
Practice Address - Street 2:
Practice Address - City:ELKINS PARK
Practice Address - State:PA
Practice Address - Zip Code:19027-1077
Practice Address - Country:US
Practice Address - Phone:215-459-0294
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-09-25
Last Update Date:2024-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Single Specialty