Aba360

Primary specialty

Community/Behavioral Health AgencyTaxonomy code 251S00000X

Legal business name

ABA360

Practice address

1072 Madison Ave Ste 400
Lakewood, NJ 08701-2650

Phone

(718) 633-4411

NPI assigned

May 11, 2020

Last updated

Jan 12, 2022By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Israel Benedek

Title

Member

Phone

(718) 336-6073

Specialties & licenses 1

Addresses

Other names 1

• CB Supports of NJ Former legal business name

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1589155200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1641945600000",
    "number": "1932721149",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1072 MADISON AVE STE 400",
            "city": "LAKEWOOD",
            "state": "NJ",
            "postal_code": "087012650"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1072 MADISON AVE STE 400",
            "city": "LAKEWOOD",
            "state": "NJ",
            "postal_code": "087012650",
            "telephone_number": "718-633-4411"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ABA360",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-05-11",
        "last_updated": "2022-01-12",
        "certification_date": "2022-01-12",
        "status": "A",
        "authorized_official_last_name": "BENEDEK",
        "authorized_official_first_name": "ISRAEL",
        "authorized_official_title_or_position": "MEMBER",
        "authorized_official_telephone_number": "718-336-6073"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "CB Supports of NJ",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

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• Abc Therapy,LP
• David Abdurachmanov

• Community/Behavioral Health Agency in Lakewood, NJ
• Providers in Lakewood, NJ by specialty
• Community/Behavioral Health Agency in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 12, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.