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General NPI Number Information
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NPI Number | 1437701844
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Entity Type | Organization
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Legal Business Name | FATAJ TRANSITION & LEARNING CENTER, LLC
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Dates
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Enumeration Date | 07/15/2019
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Last Update Date | 11/18/2024
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Provider Practice Location Address
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Address Line | 2610 ORANGE CENTER BLVD FL 32818
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City | ORLANDO
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State | FL
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Zip | 32805-3546
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Country | US
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Telephone | 407-601-0491
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Fax | 407-395-3487
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Provider Business Mailing Address
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Address Line | 2314 PESARO CIR
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City | OCOEE
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State | FL
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Zip | 34761-5005
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Country | US
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Telephone | 407-601-0491
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Fax | 407-395-3487
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Authorized Official
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Title or Position | DIRECTOR
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Name | LATEISHA JACKSON
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Credential | M.S., BCBA
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Telephone | 248-910-0440
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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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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