Provider Demographics
NPI:1649408170
Name:CENTER FOR HEALTH, LEARNING AND ACHIEVEMENT
Entity Type:Organization
Organization Name:CENTER FOR HEALTH, LEARNING AND ACHIEVEMENT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:ALICIA
Authorized Official - Middle Name:N
Authorized Official - Last Name:BRACCIA
Authorized Official - Suffix:
Authorized Official - Credentials:MA, CAS, LSP, ABSNP
Authorized Official - Phone:407-382-5551
Mailing Address - Street 1:1561 S ALAFAYA TRL
Mailing Address - Street 2:SUITE 200
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32828-8956
Mailing Address - Country:US
Mailing Address - Phone:407-382-5551
Mailing Address - Fax:
Practice Address - Street 1:1561 S ALAFAYA TRL
Practice Address - Street 2:SUITE 200
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32828-8956
Practice Address - Country:US
Practice Address - Phone:407-382-5551
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-06-23
Last Update Date:2012-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLFLSS710101Y00000X, 103TS0200X, 225X00000X
FLFLSS7701103K00000X, 235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TS0200XBehavioral Health & Social Service ProvidersPsychologistSchoolGroup - Multi-Specialty
No101Y00000XBehavioral Health & Social Service ProvidersCounselorGroup - Multi-Specialty
No103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Multi-Specialty
No225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGroup - Multi-Specialty
No235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL001021700Medicaid