Provider Demographics
NPI:1790231645
Name:A&J BEHAVIORAL HEALTH
Entity Type:Organization
Organization Name:A&J BEHAVIORAL HEALTH
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ABA THERAPIST
Authorized Official - Prefix:MS
Authorized Official - First Name:DEBBIE
Authorized Official - Middle Name:
Authorized Official - Last Name:ROLON
Authorized Official - Suffix:
Authorized Official - Credentials:MS EDUCATION
Authorized Official - Phone:718-404-1652
Mailing Address - Street 1:762 HART STREET
Mailing Address - Street 2:APT 1A
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11237
Mailing Address - Country:US
Mailing Address - Phone:718-404-1652
Mailing Address - Fax:
Practice Address - Street 1:762 HART ST
Practice Address - Street 2:APT 1A
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11237-3539
Practice Address - Country:US
Practice Address - Phone:718-404-1652
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-08-31
Last Update Date:2016-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY103K00000X252Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes252Y00000XAgenciesEarly Intervention Provider Agency