Provider Demographics
NPI:1619714912
Name:AUTISM ACHIEVERS CENTER LLC
Entity type:Organization
Organization Name:AUTISM ACHIEVERS CENTER LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:APRIL
Authorized Official - Middle Name:NICOLE
Authorized Official - Last Name:FOWLER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:336-624-5111
Mailing Address - Street 1:10926 QUALITY DR # 410104
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28278-8931
Mailing Address - Country:US
Mailing Address - Phone:336-624-5111
Mailing Address - Fax:
Practice Address - Street 1:10926 QUALITY DR # 410104
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28278-8931
Practice Address - Country:US
Practice Address - Phone:336-624-5111
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-07-12
Last Update Date:2024-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health