Provider Demographics
NPI:1518502194
Name:PERSPECTIVES DEVELOPMENTAL GROUP
Entity Type:Organization
Organization Name:PERSPECTIVES DEVELOPMENTAL GROUP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BCBA
Authorized Official - Prefix:
Authorized Official - First Name:KAYLA
Authorized Official - Middle Name:ALEXANDRIA
Authorized Official - Last Name:GREENE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:352-246-4640
Mailing Address - Street 1:3207 HENDERSON MILL RD APT T4
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30341-6019
Mailing Address - Country:US
Mailing Address - Phone:352-246-4640
Mailing Address - Fax:
Practice Address - Street 1:3207 HENDERSON MILL RD APT T4
Practice Address - Street 2:
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30341-6019
Practice Address - Country:US
Practice Address - Phone:352-246-4640
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-11-07
Last Update Date:2019-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Single Specialty