Provider Demographics
NPI:1003708538
Name:SELECT CARE ABA MD LLC
Entity type:Organization
Organization Name:SELECT CARE ABA MD LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGE
Authorized Official - Prefix:
Authorized Official - First Name:TOBY
Authorized Official - Middle Name:
Authorized Official - Last Name:ROTHENBERG
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:732-503-0379
Mailing Address - Street 1:1771 MADISON AVE STE 6
Mailing Address - Street 2:
Mailing Address - City:LAKEWOOD
Mailing Address - State:NJ
Mailing Address - Zip Code:08701-1267
Mailing Address - Country:US
Mailing Address - Phone:732-503-0379
Mailing Address - Fax:848-288-9217
Practice Address - Street 1:1771 MADISON AVE STE 6
Practice Address - Street 2:
Practice Address - City:LAKEWOOD
Practice Address - State:NJ
Practice Address - Zip Code:08701-1267
Practice Address - Country:US
Practice Address - Phone:732-503-0379
Practice Address - Fax:848-288-9217
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-07-18
Last Update Date:2025-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Single Specialty