Provider Demographics
NPI:1174412845
Name:BOUNCE OPCO LLC
Entity type:Organization
Organization Name:BOUNCE OPCO LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:AKIVA
Authorized Official - Middle Name:
Authorized Official - Last Name:ZWICK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:800-880-3372
Mailing Address - Street 1:400 BOULEVARD OF THE AMERICAS
Mailing Address - Street 2:SUITE 403
Mailing Address - City:LAKEWOOD
Mailing Address - State:NJ
Mailing Address - Zip Code:08701
Mailing Address - Country:US
Mailing Address - Phone:800-880-3372
Mailing Address - Fax:
Practice Address - Street 1:1910 TOWNE CENTRE BLVD STE 250
Practice Address - Street 2:
Practice Address - City:ANNAPOLIS
Practice Address - State:MD
Practice Address - Zip Code:21401-3599
Practice Address - Country:US
Practice Address - Phone:800-880-3372
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-06-30
Last Update Date:2025-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Multi-Specialty