Provider Demographics
NPI:1073939401
Name:THE OCALA AUTISM CENTER
Entity Type:Organization
Organization Name:THE OCALA AUTISM CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:SHANNON
Authorized Official - Middle Name:RENEE
Authorized Official - Last Name:GUNTER
Authorized Official - Suffix:
Authorized Official - Credentials:MS, BCBA
Authorized Official - Phone:352-425-0385
Mailing Address - Street 1:2411 SE 23RD ST
Mailing Address - Street 2:
Mailing Address - City:OCALA
Mailing Address - State:FL
Mailing Address - Zip Code:34471-8224
Mailing Address - Country:US
Mailing Address - Phone:352-425-0385
Mailing Address - Fax:
Practice Address - Street 1:7558 SW 61ST AVE STE 3
Practice Address - Street 2:
Practice Address - City:OCALA
Practice Address - State:FL
Practice Address - Zip Code:34476-8323
Practice Address - Country:US
Practice Address - Phone:352-671-5335
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-03-10
Last Update Date:2014-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Multi-Specialty