Healthcare Provider Details

I. General information

NPI: 1912882952
Provider Name (Legal Business Name): CHRISTIAN ACADEMY FOR AUTISM
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/08/2025
Last Update Date: 09/19/2025
Certification Date: 09/19/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1430 HOMESTEAD RD N
LEHIGH ACRES FL
33936-4829
US

IV. Provider business mailing address

1430 HOMESTEAD RD N
LEHIGH ACRES FL
33936-4829
US

V. Phone/Fax

Practice location:
  • Phone: 786-523-4930
  • Fax:
Mailing address:
  • Phone: 239-200-6514
  • Fax: 786-523-4930

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YS0200X
TaxonomySchool Counselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code106E00000X
TaxonomyAssistant Behavior Analyst
License Number
License Number State
# 4
Primary TaxonomyY
Taxonomy Code251300000X
TaxonomyLocal Education Agency (LEA)
License Number
License Number State

VIII. Authorized Official

Name: ESTELA RODRIGUEZ CASTRO
Title or Position: ADMIN/OWNER
Credential:
Phone: 786-420-8999