Provider Demographics
NPI:1003290107
Name:PEAK CENTER FOR AUTISM LLC
Entity Type:Organization
Organization Name:PEAK CENTER FOR AUTISM LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:TATIANA
Authorized Official - Middle Name:N
Authorized Official - Last Name:PEAK
Authorized Official - Suffix:
Authorized Official - Credentials:MA, BCBA
Authorized Official - Phone:609-614-7495
Mailing Address - Street 1:1900 BURLINGTON MOUNT HOLLY RD STE 6D
Mailing Address - Street 2:
Mailing Address - City:BURLINGTON
Mailing Address - State:NJ
Mailing Address - Zip Code:08016-4727
Mailing Address - Country:US
Mailing Address - Phone:609-614-7495
Mailing Address - Fax:
Practice Address - Street 1:1900 BURLINGTON MOUNT HOLLY RD STE 6D
Practice Address - Street 2:
Practice Address - City:BURLINGTON
Practice Address - State:NJ
Practice Address - Zip Code:08016-4727
Practice Address - Country:US
Practice Address - Phone:609-614-7495
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-07-17
Last Update Date:2022-03-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO1-15-18265251C00000X, 251S00000X, 253Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
No251C00000XAgenciesDay Training, Developmentally Disabled Services
No253Z00000XAgenciesIn Home Supportive Care