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Organization
SSP ABA SITE ONE LLC
Active
Organization
SSP ABA SITE ONE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MICHAEL KUCHTA (CEO)
(516) 353-4999
Entity
Organization
Contact information
Practice address
880 PACIFIC ST APT 1712, STAMFORD, CT 06902-0721
(516) 353-4999
Mailing address
880 PACIFIC ST APT 1712, STAMFORD, CT 06902-0721
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
—
—
251S00000X
Community/Behavioral Health Agency
—
—
261QH0700X
Hearing and Speech Clinic/Center
—
—
261QX0100X
Occupational Medicine Clinic/Center
—
—
Other
Enumeration date
05/22/2023
Last updated
05/22/2023
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