Healthcare Provider Details

I. General information

NPI: 1821833559
Provider Name (Legal Business Name): DANI BOTELHO INSTITUTE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/25/2024
Last Update Date: 03/18/2026
Certification Date: 03/18/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

82 TOTOWA RD STE 100
WAYNE NJ
07470-3114
US

IV. Provider business mailing address

82 TOTOWA RD STE 100
WAYNE NJ
07470-3114
US

V. Phone/Fax

Practice location:
  • Phone: 201-895-1076
  • Fax: 888-268-3606
Mailing address:
  • Phone: 201-895-1076
  • Fax: 888-268-3606

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: DANIELLE BOTELHO
Title or Position: BCBA
Credential:
Phone: 201-895-1076