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General NPI Number Information
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NPI Number | 1891337937
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Entity Type | Organization
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Legal Business Name | AUTISM CENTER FOR DEVELOPMENT AND BEHAVIOR
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Dates
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Enumeration Date | 10/10/2019
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Last Update Date | 08/14/2020
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Provider Practice Location Address
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Address Line | 160 SAGECREST CIR APT 103
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City | WEST MELBOURNE
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State | FL
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Zip | 32904-8664
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Country | US
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Telephone | 281-740-3080
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Fax |
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Provider Business Mailing Address
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Address Line | 160 SAGECREST CIR APT 103
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City | WEST MELBOURNE
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State | FL
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Zip | 32904-8664
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Country | US
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Telephone | 281-740-3080
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Fax |
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Authorized Official
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Title or Position | DIRECTOR.
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Name | DR. ED RIEPL
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Credential |
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Telephone | 321-301-0066
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251C00000X
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Taxonomy Name | Developmentally Disabled Services Day Training Agency
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License Number |
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License Number State |
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