Organization
GOLD HEART ABA LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
YEHOUSHUA TYBERG (OWNER)
(631) 507-7643
Entity
Organization
Contact information
Practice address
5 MACINTOSH CT, JACKSON, NJ 08527-1176
(631) 507-7643
Mailing address
5 MACINTOSH CT, JACKSON, NJ 08527-1176
(631) 507-7643
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
—
—
106S00000X
Behavior Technician
—
—
251S00000X
Community/Behavioral Health Agency
—
—
Other
Enumeration date
07/18/2023
Last updated
12/21/2023
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