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Organization
AUTISM LIVING EXPERIENCE, LLC
Active
Organization
AUTISM LIVING EXPERIENCE, LLC
Active
Other names
Autism Living Experience, LLC, Opal Autism Centers
Organization subpart
No
Provider details
NPI number
Authorized official
TODD STUCKEY (CHIEF FINANCIAL OFFICER)
(888) 392-8642
Entity
Organization
Contact information
Practice address
8604 CLIFF CAMERON DR STE 180, CHARLOTTE, NC 28269-8508
(888) 392-8642
Mailing address
1990 MAIN ST STE 750, SARASOTA, FL 34236-8000
(888) 392-8642
(888) 783-7611
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
—
—
103T00000X
Psychologist
—
—
106S00000X
Behavior Technician
—
—
251C00000X
Developmentally Disabled Services Day Training Agency
—
—
251S00000X
Community/Behavioral Health Agency
—
—
Other
Enumeration date
01/10/2022
Last updated
06/11/2026
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