Provider Demographics
NPI:1144058850
Name:CHILDRENS SPECIALIZED HOSPITAL ABA II, LLC
Entity type:Organization
Organization Name:CHILDRENS SPECIALIZED HOSPITAL ABA II, LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:
Authorized Official - Last Name:SUSSMAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:216-216-9500
Mailing Address - Street 1:175 BELGROVE DR
Mailing Address - Street 2:
Mailing Address - City:KEARNY
Mailing Address - State:NJ
Mailing Address - Zip Code:07032-1507
Mailing Address - Country:US
Mailing Address - Phone:216-216-9500
Mailing Address - Fax:
Practice Address - Street 1:12240 INDIAN CREEK CT
Practice Address - Street 2:
Practice Address - City:BELTSVILLE
Practice Address - State:MD
Practice Address - Zip Code:20705-1242
Practice Address - Country:US
Practice Address - Phone:844-854-2583
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-07-24
Last Update Date:2025-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Multi-Specialty
No261QM1300XAmbulatory Health Care FacilitiesClinic/CenterMulti-SpecialtyGroup - Multi-Specialty