Provider Demographics
NPI:1730440827
Name:ABA SOLUTIONS BY PAM ELLIS, LLC
Entity type:Organization
Organization Name:ABA SOLUTIONS BY PAM ELLIS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:DENNIS
Authorized Official - Middle Name:GRANT
Authorized Official - Last Name:ELLIS
Authorized Official - Suffix:JR
Authorized Official - Credentials:
Authorized Official - Phone:580-483-4554
Mailing Address - Street 1:5504 JIM AVE
Mailing Address - Street 2:
Mailing Address - City:KILLEEN
Mailing Address - State:TX
Mailing Address - Zip Code:76549-2555
Mailing Address - Country:US
Mailing Address - Phone:580-483-4554
Mailing Address - Fax:
Practice Address - Street 1:5504 JIM AVE
Practice Address - Street 2:
Practice Address - City:KILLEEN
Practice Address - State:TX
Practice Address - Zip Code:76549-2555
Practice Address - Country:US
Practice Address - Phone:580-483-4554
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-06-05
Last Update Date:2012-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Single Specialty