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NPI Code Detail

MEDICARE: BLOSSOM ABA THERAPY NM LLC

MEDICARE: BLOSSOM ABA THERAPY NM 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
1251S00000XCommunity/Behavioral Health Agency

General Provider Information

NPI Number : 1811889264
Entity Type Code : Organization
Provider Name (Legal Business Name) : BLOSSOM ABA THERAPY NM LLC
Provider Business Mailing Address
First Line : 500 MARQUETTE AVE NW STE 1200
Second Line :
City : ALBUQUERQUE
State : NM
Zip : 87102-5312
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 500 MARQUETTE AVE NW STE 1200
Second Line :
City : ALBUQUERQUE
State : NM
Zip : 87102-5312
Country : US
Telephone Number : 857-327-5283
Fax Number :
Authorized Official
Title or Position : CEO
Name : CHAD KAUFMAN
Credential :
Telephone Number : 857-327-5283
Provider Enumeration Date : 07/18/2025
Last Update Date : 02/24/2026

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Directions to “BLOSSOM ABA THERAPY NM LLC ” Practice Location

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