Organization
BRIGHTBRIDGE ABA NEW MEXICO LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LEONARD JEGER (CEO)
(336) 245-9155
Entity
Organization
Contact information
Practice address
301 N MAIN ST STE 2434, WINSTON SALEM, NC 27101-3885
(336) 510-7910
Mailing address
743 CENTRAL AVE, WOODMERE, NY 11598-2614
(347) 268-4827
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
—
—
251S00000X
Community/Behavioral Health Agency
—
—
Other
Enumeration date
05/23/2025
Last updated
05/23/2025
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