Healthcare Provider Details
I. General information
NPI: 1598529505
Provider Name (Legal Business Name): HAPPY HEARTS ABA NJ LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 02/09/2024
Last Update Date: 04/03/2024
Certification Date: 04/03/2024
Deactivation Date:
Reactivation Date:
III. Provider practice location address
500 N FRANKLIN TPKE STE 311
RAMSEY NJ
07446-1160
US
IV. Provider business mailing address
180 PHILLIPS HILL RD STE 3-B
NEW CITY NY
10956-4132
US
V. Phone/Fax
- Phone: 317-676-4700
- Fax: 317-676-4776
- Phone:
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 103K00000X |
| Taxonomy | Behavior Analyst |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 106E00000X |
| Taxonomy | Assistant Behavior Analyst |
| License Number | |
| License Number State | |
| # 3 | |
| Primary Taxonomy | N |
| Taxonomy Code | 106S00000X |
| Taxonomy | Behavior Technician |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
PAULINA
LUU
Title or Position: DIRECTOR
Credential:
Phone: 317-676-4700