Organization
SUPPORTIVE CARE ABA GA LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. RUBEN KESHERIM (MEMBER)
(317) 936-1240
Entity
Organization
Contact information
Practice address
15 PERRY ST STE 404, NEWNAN, GA 30263-1918
(317) 936-1240
(317) 936-1241
Mailing address
15 PERRY ST STE 404, NEWNAN, GA 30263-1918
(317) 936-1240
(317) 936-1241
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
—
—
Other
Enumeration date
09/21/2022
Last updated
09/21/2022
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