Provider Demographics
NPI:1700613502
Name:COMPREHENSIVE CARE ABA, LLC
Entity type:Organization
Organization Name:COMPREHENSIVE CARE ABA, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:CLARENCE
Authorized Official - Middle Name:
Authorized Official - Last Name:CHIONG
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:408-439-2098
Mailing Address - Street 1:3578 RAMBLA PL APT 421
Mailing Address - Street 2:
Mailing Address - City:SANTA CLARA
Mailing Address - State:CA
Mailing Address - Zip Code:95051-1584
Mailing Address - Country:US
Mailing Address - Phone:408-439-2098
Mailing Address - Fax:
Practice Address - Street 1:3578 RAMBLA PL APT 421
Practice Address - Street 2:
Practice Address - City:SANTA CLARA
Practice Address - State:CA
Practice Address - Zip Code:95051-1584
Practice Address - Country:US
Practice Address - Phone:408-439-2098
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-09-16
Last Update Date:2024-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Multi-Specialty