| Divine Community Care (aba Therapy), Inc. | |
|
300 W Main St Ste 104 Northborough MA 01532-2132 | |
| (508) 375-8333 | |
| Not Available |
| Full Name | Divine Community Care (aba Therapy), Inc. |
|---|---|
| Speciality | Behavior Analyst |
| Location | 300 W Main St Ste 104, Northborough, Massachusetts |
| Authorized Official Name and Position | Sulaiman Abass Kamara (OWNER) |
| Authorized Official Contact | 5083758333 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Divine Community Care (aba Therapy), Inc. 300 W Main St Ste 104 Northborough MA 01532-2132 Ph: (508) 375-8333 | Divine Community Care (aba Therapy), Inc. 300 W Main St Ste 104 Northborough MA 01532-2132 Ph: (508) 375-8333 |
| NPI Number | 1922757962 |
|---|---|
| Provider Enumeration Date | 03/18/2022 |
| Last Update Date | 03/18/2022 |
| Certification Date | 03/18/2022 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1922757962 | NPI | - | NPPES |
| 001543112 | Other | MA | SECRETARY OF STATE |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103K00000X | Behavior Analyst | (* (Not Available)) | Primary |
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