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General NPI Number Information
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NPI Number | 1306237961
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Entity Type | Organization
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Legal Business Name | HOOM HOUSE LLC
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Dates
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Enumeration Date | 02/17/2015
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Last Update Date | 02/17/2015
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Provider Practice Location Address
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Address Line | 940 MONROE AVE NW UNIT 354
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City | GRAND RAPIDS
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State | MI
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Zip | 49503-1456
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Country | US
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Telephone | 248-464-4770
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Fax |
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Provider Business Mailing Address
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Address Line | 940 MONROE AVE NW UNIT 354
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City | GRAND RAPIDS
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State | MI
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Zip | 49503-1456
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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 | FOUNDER
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Name | MS. LAUREN MAE HOOMAIAN
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Credential | MS, BCBA
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Telephone | 248-464-4770
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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 | 1-14-10017
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License Number State | MI
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