Provider Demographics
NPI:1881383057
Name:BLOOMING CHILD DEVELOPMENT
Entity type:Organization
Organization Name:BLOOMING CHILD DEVELOPMENT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ABBY
Authorized Official - Middle Name:ABERASH
Authorized Official - Last Name:TEKIE
Authorized Official - Suffix:
Authorized Official - Credentials:BCBA
Authorized Official - Phone:310-634-4444
Mailing Address - Street 1:8901 BURTON WAY APT 401
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90048-3787
Mailing Address - Country:US
Mailing Address - Phone:310-927-0126
Mailing Address - Fax:
Practice Address - Street 1:8901 BURTON WAY APT 401
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90048-3787
Practice Address - Country:US
Practice Address - Phone:310-927-0126
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-05-03
Last Update Date:2023-08-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Single Specialty
No106E00000XBehavioral Health & Social Service ProvidersAssistant Behavior AnalystGroup - Single Specialty
No106S00000XBehavioral Health & Social Service ProvidersBehavior TechnicianGroup - Single Specialty