Provider Demographics
NPI:1467109850
Name:SWEET BLOOM ABA CHILDREN'S THERAPY CENTER
Entity type:Organization
Organization Name:SWEET BLOOM ABA CHILDREN'S THERAPY CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:FOUNDER
Authorized Official - Prefix:
Authorized Official - First Name:ENHEA
Authorized Official - Middle Name:
Authorized Official - Last Name:OH
Authorized Official - Suffix:
Authorized Official - Credentials:BCBA, LBA
Authorized Official - Phone:201-301-0308
Mailing Address - Street 1:44 GODWIN AVE STE 300
Mailing Address - Street 2:
Mailing Address - City:MIDLAND PARK
Mailing Address - State:NJ
Mailing Address - Zip Code:07432-1959
Mailing Address - Country:US
Mailing Address - Phone:201-301-0308
Mailing Address - Fax:201-301-0309
Practice Address - Street 1:44 GODWIN AVE STE 300
Practice Address - Street 2:
Practice Address - City:MIDLAND PARK
Practice Address - State:NJ
Practice Address - Zip Code:07432-1959
Practice Address - Country:US
Practice Address - Phone:201-301-0308
Practice Address - Fax:201-301-0309
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-03-04
Last Update Date:2025-01-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Multi-Specialty