Provider Demographics
NPI:1235954439
Name:ALL STAR ABA II
Entity type:Organization
Organization Name:ALL STAR ABA II
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:AARON
Authorized Official - Middle Name:
Authorized Official - Last Name:LANDAU
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:347-623-8142
Mailing Address - Street 1:1517 REISTERSTOWN RD # 211
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21208-4325
Mailing Address - Country:US
Mailing Address - Phone:347-623-8142
Mailing Address - Fax:
Practice Address - Street 1:1517 REISTERSTOWN RD # 211
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21208-4325
Practice Address - Country:US
Practice Address - Phone:347-623-8142
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-11-21
Last Update Date:2024-11-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health