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Organization
CRYSTAL LAKE SUPPORTIVE ENVIRONMENTS
Active
Organization
CRYSTAL LAKE SUPPORTIVE ENVIRONMENTS
Active
Other names
Attain, Inc.
Organization subpart
No
Provider details
NPI number
Authorized official
MR. CRAIG COOK PH.D., BCBA-D (EXECUTIVE DIRECTOR)
(407) 965-3055
Entity
Organization
Contact information
Practice address
2710 STATEN AVE, SUITE A, ORLANDO, FL 32804-4211
(407) 965-3018
(877) 690-2003
Mailing address
2710 STATEN AVE, SUITE A, ORLANDO, FL 32804-4211
(407) 965-3018
(877) 690-2003
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
671009396
—
FL
Enumeration date
09/19/2013
Last updated
11/18/2013
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