Healthcare Provider Details

I. General information

NPI: 1851982037
Provider Name (Legal Business Name): GTG AUTISM CENTER LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/29/2021
Last Update Date: 11/21/2025
Certification Date: 11/21/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3131 LAWRENCEVILLE SUWANEE RD STE A3
SUWANEE GA
30024-7488
US

IV. Provider business mailing address

3131 LAWRENCEVILLE SUWANEE RD STE A3
SUWANEE GA
30024-7488
US

V. Phone/Fax

Practice location:
  • Phone: 470-589-1876
  • Fax:
Mailing address:
  • Phone: 470-589-1876
  • 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 Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code261QH0700X
TaxonomyHearing and Speech Clinic/Center
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code261QX0100X
TaxonomyOccupational Medicine Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: AMBER FOLGER
Title or Position: MEMBER
Credential:
Phone: 470-589-1876