Organization
BLOSSOM ABA THERAPY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. MOSHE NOSSON JACOBOVITCH (MANAGER)
(216) 215-6495
Entity
Organization
Contact information
Practice address
1910 PACIFIC AVE SUITE 2000-1359, AUSTIN, TX 75201
(216) 215-6495
Mailing address
1910 PACIFIC AVE SUITE 2000-1359, AUSTIN, TX 75201
(216) 215-6495
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Enumeration date
06/08/2022
Last updated
06/08/2022
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