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Organization
BLUE BALLOON NJ LLC
Active
Organization
BLUE BALLOON NJ LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
AVERY EISENREICH (MEMBER)
(201) 216-9500
Entity
Organization
Contact information
Practice address
175 BELGROVE DR, KEARNY, NJ 07032-1507
(201) 216-9500
Mailing address
175 BELGROVE DR, KEARNY, NJ 07032-1507
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
—
—
103T00000X
Psychologist
—
—
225X00000X
Occupational Therapist
—
—
235Z00000X
Speech-Language Pathologist
—
—
Other
Enumeration date
12/10/2020
Last updated
05/27/2021
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