Provider Demographics
NPI:1861281891
Name:GIGGLES AND GOALS AUTISM THERAPY, LLC
Entity type:Organization
Organization Name:GIGGLES AND GOALS AUTISM THERAPY, LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:TAMMY
Authorized Official - Middle Name:
Authorized Official - Last Name:JERNIGAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:936-404-8754
Mailing Address - Street 1:PO BOX 319
Mailing Address - Street 2:
Mailing Address - City:WELLS
Mailing Address - State:TX
Mailing Address - Zip Code:75976-9002
Mailing Address - Country:US
Mailing Address - Phone:936-404-8754
Mailing Address - Fax:
Practice Address - Street 1:1741 NEWNAN CROSSING BLVD E STE 1-423
Practice Address - Street 2:
Practice Address - City:NEWNAN
Practice Address - State:GA
Practice Address - Zip Code:30265-1599
Practice Address - Country:US
Practice Address - Phone:936-404-8754
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-05-05
Last Update Date:2025-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health