Provider Demographics
NPI: | 1629678974 |
---|---|
Name: | PERSONALIZED ACADEMY OF LEARNING INC |
Entity Type: | Organization |
Organization Name: | PERSONALIZED ACADEMY OF LEARNING INC |
Other - Org Name: | |
Other - Org Type: | |
Authorized Official - Title/Position: | CHIEF EXECUTIVE OFFICER |
Authorized Official - Prefix: | |
Authorized Official - First Name: | KRISTI |
Authorized Official - Middle Name: | |
Authorized Official - Last Name: | GETSON |
Authorized Official - Suffix: | |
Authorized Official - Credentials: | |
Authorized Official - Phone: | 240-298-0222 |
Mailing Address - Street 1: | 22593 THREE NOTCH RD |
Mailing Address - Street 2: | |
Mailing Address - City: | CALIFORNIA |
Mailing Address - State: | MD |
Mailing Address - Zip Code: | 20619-3054 |
Mailing Address - Country: | US |
Mailing Address - Phone: | 240-298-0222 |
Mailing Address - Fax: | |
Practice Address - Street 1: | 20945 GREAT MILLS RD STE 201 |
Practice Address - Street 2: | |
Practice Address - City: | LEXINGTON PARK |
Practice Address - State: | MD |
Practice Address - Zip Code: | 20653-5304 |
Practice Address - Country: | US |
Practice Address - Phone: | 240-298-0222 |
Practice Address - Fax: | |
EIN: | <UNAVAIL> |
Is Organization Subpart?: | No |
Parent Organization LBN: | |
Parent Organization TIN: | |
Enumeration Date: | 2020-10-27 |
Last Update Date: | 2020-10-27 |
Deactivation Date: | |
Deactivation Code: | |
Reactivation Date: |
Provider Taxonomies
Primary? | Code | Type | Classification | Specialization | Group |
---|---|---|---|---|---|
Yes | 261Q00000X | Ambulatory Health Care Facilities | Clinic/Center | ||
No | 103K00000X | Behavioral Health & Social Service Providers | Behavior Analyst | Group - Multi-Specialty | |
No | 103TC2200X | Behavioral Health & Social Service Providers | Psychologist | Clinical Child & Adolescent | Group - Multi-Specialty |
No | 106S00000X | Behavioral Health & Social Service Providers | Behavior Technician | Group - Multi-Specialty | |
No | 2251P0200X | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Physical Therapist | Pediatrics | Group - Multi-Specialty |
No | 225XP0200X | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Occupational Therapist | Pediatrics | Group - Multi-Specialty |
No | 235Z00000X | Speech, Language and Hearing Service Providers | Speech-Language Pathologist | Group - Multi-Specialty | |
No | 252Y00000X | Agencies | Early Intervention Provider Agency | ||
No | 261QD1600X | Ambulatory Health Care Facilities | Clinic/Center | Developmental Disabilities | |
No | 261QH0700X | Ambulatory Health Care Facilities | Clinic/Center | Hearing and Speech | |
No | 261QM1300X | Ambulatory Health Care Facilities | Clinic/Center | Multi-Specialty | |
No | 261QP2000X | Ambulatory Health Care Facilities | Clinic/Center | Physical Therapy | Group - Multi-Specialty |
No | 261QX0100X | Ambulatory Health Care Facilities | Clinic/Center | Occupational Medicine | Group - Multi-Specialty |