Healthcare Provider Details

I. General information

NPI: 1053102673
Provider Name (Legal Business Name): LITTLE ACORN ABA MN
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/14/2025
Last Update Date: 05/14/2025
Certification Date: 05/14/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5201 EDEN AVE STE 300
EDINA MN
55436-2315
US

IV. Provider business mailing address

42 LENOX DR
LAKEWOOD NJ
08701-7419
US

V. Phone/Fax

Practice location:
  • Phone: 732-703-0594
  • Fax:
Mailing address:
  • Phone: 732-703-0594
  • 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 Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State

VIII. Authorized Official

Name: SHMUEL S LANDYNSKI
Title or Position: CEO
Credential:
Phone: 732-703-0594