Healthcare Provider Details

I. General information

NPI: 1306439427
Provider Name (Legal Business Name): APPLAUD AUTISM SERVICES GA LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/19/2021
Last Update Date: 02/19/2021
Certification Date: 02/19/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5555 GLENRIDGE CONNECTOR FL 2
ATLANTA GA
30342-4759
US

IV. Provider business mailing address

4 CHISWICK DR
JACKSON NJ
08527-1260
US

V. Phone/Fax

Practice location:
  • Phone: 404-654-3236
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code106E00000X
TaxonomyAssistant Behavior Analyst
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number
License Number State

VIII. Authorized Official

Name: JACOB KATZ
Title or Position: DIRECTOR
Credential:
Phone: 404-654-3236