Provider Demographics
NPI:1013700160
Name:ABA SUPPORTIVE CARE OH LLC
Entity type:Organization
Organization Name:ABA SUPPORTIVE CARE OH LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:RUBEN
Authorized Official - Middle Name:
Authorized Official - Last Name:KESHERIM
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:317-936-1240
Mailing Address - Street 1:6150 ENTERPRISE PKWY STE 239
Mailing Address - Street 2:
Mailing Address - City:SOLON
Mailing Address - State:OH
Mailing Address - Zip Code:44139-2755
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:6150 ENTERPRISE PKWY STE 239
Practice Address - Street 2:
Practice Address - City:SOLON
Practice Address - State:OH
Practice Address - Zip Code:44139-2755
Practice Address - Country:US
Practice Address - Phone:317-936-1240
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-05-22
Last Update Date:2025-05-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Single Specialty