Provider Demographics
NPI:1619769510
Name:SKY CARE ABA INDIANA LLC
Entity type:Organization
Organization Name:SKY CARE ABA INDIANA LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF OPERATING OFFICER
Authorized Official - Prefix:MR
Authorized Official - First Name:JONATHAN
Authorized Official - Middle Name:
Authorized Official - Last Name:SIMENSEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:609-668-8042
Mailing Address - Street 1:1999 CEDARBRIDGE AVE STE 2B
Mailing Address - Street 2:
Mailing Address - City:LAKEWOOD
Mailing Address - State:NJ
Mailing Address - Zip Code:08701-7048
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:155 E MARKET ST FL 7
Practice Address - Street 2:
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46204-3294
Practice Address - Country:US
Practice Address - Phone:844-390-6265
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:SKY CARE ABA LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2025-05-19
Last Update Date:2025-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Single Specialty