Healthcare Provider Details

I. General information

NPI: 1720919129
Provider Name (Legal Business Name): KIDS FIRST THERAPY NEW MEXICO LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/26/2026
Last Update Date: 05/26/2026
Certification Date: 05/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8206 LOUISIANA BLVD NE STE A
ALBUQUERQUE NM
87113-1738
US

IV. Provider business mailing address

1 PARAGON DR STE 100
MONTVALE NJ
07645-1728
US

V. Phone/Fax

Practice location:
  • Phone: 845-425-2299
  • Fax:
Mailing address:
  • Phone: 845-425-2299
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number
License Number State

VIII. Authorized Official

Name: SHRAGA GOLD
Title or Position: CEO/OWNER
Credential:
Phone: 845-425-2299