Provider Demographics
NPI:1003581430
Name:STAGES LEARNING CENTER FOR AUTISM EDUCATION
Entity Type:Organization
Organization Name:STAGES LEARNING CENTER FOR AUTISM EDUCATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:ANGELA
Authorized Official - Middle Name:
Authorized Official - Last Name:NELSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:530-892-1112
Mailing Address - Street 1:PO BOX 460
Mailing Address - Street 2:
Mailing Address - City:VISTA
Mailing Address - State:CA
Mailing Address - Zip Code:92085-0460
Mailing Address - Country:US
Mailing Address - Phone:530-892-1122
Mailing Address - Fax:
Practice Address - Street 1:2581 PIONEER AVE STE A
Practice Address - Street 2:
Practice Address - City:VISTA
Practice Address - State:CA
Practice Address - Zip Code:92081-8414
Practice Address - Country:US
Practice Address - Phone:530-892-1112
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-08-09
Last Update Date:2021-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD1600XAmbulatory Health Care FacilitiesClinic/CenterDevelopmental Disabilities