Provider Demographics
NPI:1659732535
Name:PERFECT PIECE LLC
Entity Type:Organization
Organization Name:PERFECT PIECE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BCBA/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MATOTOPA
Authorized Official - Middle Name:
Authorized Official - Last Name:AUGUSTINE
Authorized Official - Suffix:
Authorized Official - Credentials:MS, BCBA
Authorized Official - Phone:508-733-6392
Mailing Address - Street 1:150 WASHINGTON AVE
Mailing Address - Street 2:201
Mailing Address - City:SANTA FE
Mailing Address - State:NM
Mailing Address - Zip Code:87501-2073
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:150 WASHINGTON AVE
Practice Address - Street 2:201
Practice Address - City:SANTA FE
Practice Address - State:NM
Practice Address - Zip Code:87501-2073
Practice Address - Country:US
Practice Address - Phone:508-733-6392
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-03-18
Last Update Date:2016-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA1-10-7448251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health