Provider Demographics
NPI:1881825107
Name:TRANSFORMATIONS AUTISM TREATMENT CENTER
Entity Type:Organization
Organization Name:TRANSFORMATIONS AUTISM TREATMENT CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:TRACY
Authorized Official - Middle Name:
Authorized Official - Last Name:PALM
Authorized Official - Suffix:
Authorized Official - Credentials:MS, BCBA
Authorized Official - Phone:901-231-1931
Mailing Address - Street 1:2445 CARROLLWOOD LN
Mailing Address - Street 2:
Mailing Address - City:CORDOVA
Mailing Address - State:TN
Mailing Address - Zip Code:38016-4623
Mailing Address - Country:US
Mailing Address - Phone:901-231-1931
Mailing Address - Fax:901-592-0131
Practice Address - Street 1:2445 CARROLLWOOD LN
Practice Address - Street 2:
Practice Address - City:CORDOVA
Practice Address - State:TN
Practice Address - Zip Code:38016-4623
Practice Address - Country:US
Practice Address - Phone:901-231-1931
Practice Address - Fax:901-592-0131
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-08-04
Last Update Date:2009-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Single Specialty