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General NPI Number Information
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NPI Number | 1275001828
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Entity Type | Organization
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Legal Business Name | RIPPLE EFFECTS AUTISM LEARNING CENTER, LLC
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Dates
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Enumeration Date | 11/12/2018
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Last Update Date | 08/15/2024
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Provider Practice Location Address
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Address Line | 06321 BLUE STAR MEMORIAL HWY
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City | SOUTH HAVEN
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State | MI
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Zip | 49090-7775
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Country | US
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Telephone | 859-553-2472
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Fax |
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Provider Business Mailing Address
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Address Line | 9825 PINE VIEW DR
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City | PORTAGE
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State | MI
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Zip | 49002-7055
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Country | US
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Telephone | 859-553-2472
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | LAUREN CAVALLI
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Credential | BCBA
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Telephone | 859-553-2472
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 385H00000X
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Taxonomy Name | Respite Care
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 103K00000X
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Taxonomy Name | Behavior Analyst
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License Number |
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License Number State |
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