Provider Demographics
NPI:1891337937
Name:AUTISM CENTER FOR DEVELOPMENT AND BEHAVIOR
Entity Type:Organization
Organization Name:AUTISM CENTER FOR DEVELOPMENT AND BEHAVIOR
Other - Org Name:ACDB
Other - Org Type:Other Name
Authorized Official - Title/Position:DIRECTOR.
Authorized Official - Prefix:DR
Authorized Official - First Name:ED
Authorized Official - Middle Name:
Authorized Official - Last Name:RIEPL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:321-301-0066
Mailing Address - Street 1:160 SAGECREST CIR APT 103
Mailing Address - Street 2:
Mailing Address - City:WEST MELBOURNE
Mailing Address - State:FL
Mailing Address - Zip Code:32904-8664
Mailing Address - Country:US
Mailing Address - Phone:281-740-3080
Mailing Address - Fax:
Practice Address - Street 1:160 SAGECREST CIR APT 103
Practice Address - Street 2:
Practice Address - City:WEST MELBOURNE
Practice Address - State:FL
Practice Address - Zip Code:32904-8664
Practice Address - Country:US
Practice Address - Phone:281-740-3080
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-10-10
Last Update Date:2020-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251C00000XAgenciesDay Training, Developmentally Disabled Services