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General NPI Number Information
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NPI Number | 1780432831
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Entity Type | Organization
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Legal Business Name | CHILDRENS SPECIALIZED HOSPITAL ABA, LLC.
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Dates
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Enumeration Date | 05/13/2024
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Last Update Date | 12/01/2025
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Provider Practice Location Address
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Address Line | 178 W VETERANS HWY
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City | JACKSON
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State | NJ
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Zip | 08527-3410
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Country | US
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Telephone | 201-979-1336
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Fax | 908-940-0338
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Provider Business Mailing Address
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Address Line | 175 BELGROVE DR
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City | KEARNY
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State | NJ
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Zip | 07032-1507
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Country | US
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Telephone | 216-216-9500
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | DAVID SUSSMAN
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Credential |
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Telephone | 216-216-9500
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM1300X
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Taxonomy Name | Multi-Specialty Clinic/Center
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License Number |
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License Number State |
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Taxonomy #2
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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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