MEDICARE: HORIZON BLUE ABA NJ LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	103K00000X	Behavior Analyst

General Provider Information

NPI Number	:	1710849260
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	HORIZON BLUE ABA NJ LLC

Provider Business Mailing Address
First Line	:	283 LENOX AVE
Second Line	:
City	:	LONG BRANCH
State	:	NJ
Zip	:	07740-5022
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	283 LENOX AVE
Second Line	:
City	:	LONG BRANCH
State	:	NJ
Zip	:	07740-5022
Country	:	US
Telephone Number	:	212-111-0000
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	SOLOMON BAILEY
Credential	:
Telephone Number	:	212-111-0000

Provider Enumeration Date	:	12/02/2025
Last Update Date	:	12/02/2025

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