Provider Demographics
NPI:1083494033
Name:AMAZE ABA NORTH CAROLINA
Entity Type:Organization
Organization Name:AMAZE ABA NORTH CAROLINA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:JOSEPH
Authorized Official - Middle Name:
Authorized Official - Last Name:SCHWARTZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:470-203-9984
Mailing Address - Street 1:5000 CENTRE GREEN WAY STE 500
Mailing Address - Street 2:
Mailing Address - City:CARY
Mailing Address - State:NC
Mailing Address - Zip Code:27513-5821
Mailing Address - Country:US
Mailing Address - Phone:470-203-9984
Mailing Address - Fax:
Practice Address - Street 1:5000 CENTRE GREEN WAY STE 500
Practice Address - Street 2:
Practice Address - City:CARY
Practice Address - State:NC
Practice Address - Zip Code:27513-5821
Practice Address - Country:US
Practice Address - Phone:470-203-9984
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-10-05
Last Update Date:2023-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health