Provider Demographics
NPI:1457734824
Name:CATCH, LLC
Entity Type:Organization
Organization Name:CATCH, LLC
Other - Org Name:CUPP'S AUTISM THERAPY AND CONSULTING IN HOME
Other - Org Type:Other Name
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:LEXIE
Authorized Official - Middle Name:JO
Authorized Official - Last Name:CUPP
Authorized Official - Suffix:
Authorized Official - Credentials:MED, BCBA
Authorized Official - Phone:318-416-2208
Mailing Address - Street 1:17095 FENTON DEDEAUX RD
Mailing Address - Street 2:
Mailing Address - City:KILN
Mailing Address - State:MS
Mailing Address - Zip Code:39556-6931
Mailing Address - Country:US
Mailing Address - Phone:318-416-2208
Mailing Address - Fax:
Practice Address - Street 1:17095 FENTON DEDEAUX RD
Practice Address - Street 2:
Practice Address - City:KILN
Practice Address - State:MS
Practice Address - Zip Code:39556-6931
Practice Address - Country:US
Practice Address - Phone:318-416-2208
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-07-03
Last Update Date:2015-07-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
11314174103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Single Specialty