Provider Demographics
NPI:1972247518
Name:AUTISM AND DEVELOPMENT THERAPY CENTER, INC.
Entity type:Organization
Organization Name:AUTISM AND DEVELOPMENT THERAPY CENTER, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:ONEYDA
Authorized Official - Middle Name:
Authorized Official - Last Name:PEREZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:407-946-3310
Mailing Address - Street 1:4312 W OAK RIDGE RD
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32809-4452
Mailing Address - Country:US
Mailing Address - Phone:407-946-3310
Mailing Address - Fax:407-307-2328
Practice Address - Street 1:6900 TAVISTOCK LAKES BLVD STE 400
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32827-7593
Practice Address - Country:US
Practice Address - Phone:305-992-8097
Practice Address - Fax:407-307-2328
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-04-20
Last Update Date:2022-04-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center
No103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Single Specialty