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General NPI Number Information
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NPI Number | 1467109850
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Entity Type | Organization
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Legal Business Name | SWEET BLOOM ABA CHILDREN'S THERAPY CENTER
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Dates
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Enumeration Date | 03/04/2022
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Last Update Date | 01/02/2025
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Provider Practice Location Address
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Address Line | 44 GODWIN AVE STE 300
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City | MIDLAND PARK
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State | NJ
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Zip | 07432-1959
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Country | US
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Telephone | 201-301-0308
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Fax | 201-301-0309
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Provider Business Mailing Address
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Address Line | 44 GODWIN AVE STE 300
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City | MIDLAND PARK
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State | NJ
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Zip | 07432-1959
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Country | US
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Telephone | 201-301-0308
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Fax | 201-301-0309
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Authorized Official
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Title or Position | FOUNDER
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Name | ENHEA OH
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Credential | BCBA, LBA
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Telephone | 201-301-0308
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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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