Provider Demographics
NPI:1033934534
Name:ADAPTIVE PEDIATRICS OPCO LLC
Entity type:Organization
Organization Name:ADAPTIVE PEDIATRICS OPCO LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:COO
Authorized Official - Prefix:
Authorized Official - First Name:TZIVIA
Authorized Official - Middle Name:
Authorized Official - Last Name:WEINSTEIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:301-221-5594
Mailing Address - Street 1:249 WILLIAMSON RD STE 200
Mailing Address - Street 2:
Mailing Address - City:MOORESVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28117-6863
Mailing Address - Country:US
Mailing Address - Phone:301-221-5594
Mailing Address - Fax:
Practice Address - Street 1:249 WILLIAMSON RD STE 200
Practice Address - Street 2:
Practice Address - City:MOORESVILLE
Practice Address - State:NC
Practice Address - Zip Code:28117-6863
Practice Address - Country:US
Practice Address - Phone:301-221-5594
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-11-19
Last Update Date:2025-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Multi-Specialty
No106E00000XBehavioral Health & Social Service ProvidersAssistant Behavior AnalystGroup - Multi-Specialty
No106S00000XBehavioral Health & Social Service ProvidersBehavior TechnicianGroup - Multi-Specialty
No251S00000XAgenciesCommunity/Behavioral HealthGroup - Multi-Specialty