Healthcare Provider Details

I. General information

NPI: 1033921143
Provider Name (Legal Business Name): GOLDEN TOUCH ABA ID, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/24/2025
Last Update Date: 01/24/2025
Certification Date: 01/20/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8059 W PREECE DR
BOISE ID
83704-9052
US

IV. Provider business mailing address

1515 PINE ST STE 230
LAKEWOOD NJ
08701-4994
US

V. Phone/Fax

Practice location:
  • Phone: 801-630-5443
  • Fax: 732-746-0531
Mailing address:
  • Phone: 732-746-0531
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number
License Number State

VIII. Authorized Official

Name: AHRON GOLDSTEIN
Title or Position: DIRECTOR
Credential:
Phone: 732-746-0531