Provider Demographics
NPI:1295489839
Name:ANGELCARE ABA, LLC
Entity type:Organization
Organization Name:ANGELCARE ABA, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:BLIMA
Authorized Official - Middle Name:
Authorized Official - Last Name:BREZEL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:302-990-2323
Mailing Address - Street 1:146 E KING ST STE 1120
Mailing Address - Street 2:
Mailing Address - City:LANCASTER
Mailing Address - State:PA
Mailing Address - Zip Code:17602-2832
Mailing Address - Country:US
Mailing Address - Phone:302-990-2323
Mailing Address - Fax:844-440-2323
Practice Address - Street 1:100 S BROAD ST STE 1930
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19110-1025
Practice Address - Country:US
Practice Address - Phone:302-990-2323
Practice Address - Fax:844-440-2323
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-02-11
Last Update Date:2024-12-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Single Specialty
No251S00000XAgenciesCommunity/Behavioral HealthGroup - Single Specialty