Organization
TIDAL BEHAVIORAL ABA NJ LLC
Active
Other names
Tidal Behavioral ABA NJ LLC
Organization subpart
No
Provider details
NPI number
Authorized official
JACK ELIAS (CONTROLLER)
(171) 873-6568
Entity
Organization
Contact information
Practice address
820 BEAR TAVERN RD, EWING, NJ 08628-1021
(718) 736-5689
Mailing address
7 STERLING PL, LAWRENCE, NY 11559-2414
(171) 873-6568
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Enumeration date
02/12/2024
Last updated
02/12/2024
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