Provider Demographics
NPI:1902606767
Name:MICHIGAN ABA PROVIDERS INC
Entity type:Organization
Organization Name:MICHIGAN ABA PROVIDERS INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:GITTY
Authorized Official - Middle Name:
Authorized Official - Last Name:ENDZWEIG
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:866-352-5010
Mailing Address - Street 1:4601 SHERIDAN ST STE 213
Mailing Address - Street 2:
Mailing Address - City:HOLLYWOOD
Mailing Address - State:FL
Mailing Address - Zip Code:33021-3432
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:2751 E JEFFERSON AVE STE 400
Practice Address - Street 2:
Practice Address - City:DETROIT
Practice Address - State:MI
Practice Address - Zip Code:48207-4105
Practice Address - Country:US
Practice Address - Phone:231-289-1545
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-03-19
Last Update Date:2025-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Single Specialty