Provider Demographics
NPI:1164839569
Name:WRAP AUTISM CENTER
Entity Type:Organization
Organization Name:WRAP AUTISM CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PROGRAM FACILITATOR
Authorized Official - Prefix:
Authorized Official - First Name:NAI
Authorized Official - Middle Name:
Authorized Official - Last Name:BEARD
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:678-580-3925
Mailing Address - Street 1:1851 PEELER ROAD
Mailing Address - Street 2:SUITE B
Mailing Address - City:DUNWOODY
Mailing Address - State:GA
Mailing Address - Zip Code:30338
Mailing Address - Country:US
Mailing Address - Phone:678-580-3925
Mailing Address - Fax:
Practice Address - Street 1:1851 PEELER RD
Practice Address - Street 2:SUITE B
Practice Address - City:DUNWOODY
Practice Address - State:GA
Practice Address - Zip Code:30338-5794
Practice Address - Country:US
Practice Address - Phone:678-580-3925
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-07-17
Last Update Date:2014-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Single Specialty