| Blue Blossom Care Aba Therapy Lllp | |
|
1431 Silvergate Way Winder GA 30680-6101 | |
| (470) 561-0340 | |
| Not Available |
| Full Name | Blue Blossom Care Aba Therapy Lllp |
|---|---|
| Speciality | Behavior Analyst |
| Location | 1431 Silvergate Way, Winder, Georgia |
| Authorized Official Name and Position | Manuel Alejandro Perez (CEO/OWNER) |
| Authorized Official Contact | 4705610340 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Blue Blossom Care Aba Therapy Lllp 1431 Silvergate Way Winder GA 30680-6101 Ph: (470) 561-0340 | Blue Blossom Care Aba Therapy Lllp 1431 Silvergate Way Winder GA 30680-6101 Ph: (470) 561-0340 |
| NPI Number | 1770287823 |
|---|---|
| Provider Enumeration Date | 03/30/2023 |
| Last Update Date | 03/30/2023 |
| Certification Date | 03/30/2023 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1770287823 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103K00000X | Behavior Analyst | (* (Not Available)) | Primary |
| 106S00000X | Behavior Technician | (* (Not Available)) | Secondary |
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