Healthcare Provider Details

I. General information

NPI: 1457125585
Provider Name (Legal Business Name): ALWAYS SHINING ABA LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/09/2023
Last Update Date: 11/26/2023
Certification Date: 11/16/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

763 KENNEDY BLVD FLOOR 1
BAYONNE NJ
07002
US

IV. Provider business mailing address

701 STATE RT 440 STE 16
JERSEY CITY NJ
07304-1069
US

V. Phone/Fax

Practice location:
  • Phone: 201-617-3388
  • Fax:
Mailing address:
  • Phone: 201-528-3696
  • 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: JASMINE HERNANDEZ
Title or Position: CO-OWNER
Credential:
Phone: 201-528-3696