Provider Demographics
NPI:1730903550
Name:ADVANCEABLE NC ABA LLC
Entity type:Organization
Organization Name:ADVANCEABLE NC ABA LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:
Authorized Official - Last Name:WASSNER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:948-222-4968
Mailing Address - Street 1:4214 W WENDOVER AVE STE 1085
Mailing Address - Street 2:
Mailing Address - City:GREENSBORO
Mailing Address - State:NC
Mailing Address - Zip Code:27407-1909
Mailing Address - Country:US
Mailing Address - Phone:948-222-4968
Mailing Address - Fax:948-222-4968
Practice Address - Street 1:3905 INDEPENDENCE BLVD. SUITE. B 1006
Practice Address - Street 2:
Practice Address - City:WILMINGTON
Practice Address - State:NC
Practice Address - Zip Code:28412
Practice Address - Country:US
Practice Address - Phone:948-222-4968
Practice Address - Fax:804-710-2054
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-11-08
Last Update Date:2025-04-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Multi-Specialty