Provider Demographics
NPI:1891431300
Name:PALMA ACADEMY OF LEARNING, LLC
Entity Type:Organization
Organization Name:PALMA ACADEMY OF LEARNING, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:LARRY
Authorized Official - Middle Name:F
Authorized Official - Last Name:WOLPERT
Authorized Official - Suffix:JR
Authorized Official - Credentials:
Authorized Official - Phone:813-967-5706
Mailing Address - Street 1:5828 TERNCREST DR
Mailing Address - Street 2:
Mailing Address - City:LITHIA
Mailing Address - State:FL
Mailing Address - Zip Code:33547-5876
Mailing Address - Country:US
Mailing Address - Phone:813-967-5706
Mailing Address - Fax:
Practice Address - Street 1:8 SOUTHPOINTE DR
Practice Address - Street 2:
Practice Address - City:PARAGOULD
Practice Address - State:AR
Practice Address - Zip Code:72450-6238
Practice Address - Country:US
Practice Address - Phone:870-565-9776
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-05-08
Last Update Date:2023-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Single Specialty