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General NPI Number Information
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NPI Number | 1811710395
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Entity Type | Organization
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Legal Business Name | HEARTWISE GEORGIA ABA LLC
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Dates
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Enumeration Date | 11/04/2024
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Last Update Date | 11/04/2024
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Provider Practice Location Address
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Address Line | 3280 PEACHTREE RD NE # 7-157
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City | ATLANTA
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State | GA
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Zip | 30305-2430
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Country | US
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Telephone | 718-400-9077
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Fax |
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Provider Business Mailing Address
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Address Line | 4403 15TH AVE STE 499
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City | BROOKLYN
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State | NY
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Zip | 11219-1604
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Country | US
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Telephone | 718-400-9077
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | ZALMEN LOVI
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Credential |
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Telephone | 718-400-9077
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 106S00000X
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Taxonomy Name | Behavior Technician
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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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