Provider Demographics
NPI:1578222147
Name:FILLING IN THE GAPS ABA THERAPY CENTER INC.
Entity Type:Organization
Organization Name:FILLING IN THE GAPS ABA THERAPY CENTER INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BUSINESS MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:NIKITA
Authorized Official - Middle Name:
Authorized Official - Last Name:CHALMERS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:901-230-9580
Mailing Address - Street 1:4397 WHISPER SPRING DR
Mailing Address - Street 2:
Mailing Address - City:COLLIERVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:38017-8547
Mailing Address - Country:US
Mailing Address - Phone:901-230-9580
Mailing Address - Fax:
Practice Address - Street 1:4397 WHISPER SPRING DR
Practice Address - Street 2:
Practice Address - City:COLLIERVILLE
Practice Address - State:TN
Practice Address - Zip Code:38017-8547
Practice Address - Country:US
Practice Address - Phone:901-230-9580
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-12-10
Last Update Date:2021-12-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health