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General NPI Number Information
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NPI Number | 1154004380
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Entity Type | Organization
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Legal Business Name | JADE ABA THERAPY LLC
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Dates
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Enumeration Date | 08/14/2023
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Last Update Date | 08/14/2023
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Provider Practice Location Address
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Address Line | 822 GUILFORD AVE
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City | BALTIMORE
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State | MD
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Zip | 21202-3707
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Country | US
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Telephone | 917-578-7408
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Fax |
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Provider Business Mailing Address
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Address Line | 7 CAINS RD
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City | SUFFERN
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State | NY
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Zip | 10901-1703
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | AVROHOM ORLANSKY
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Credential |
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Telephone | 917-578-7408
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103K00000X
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Taxonomy Name | Behavior Analyst
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License Number |
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License Number State |
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