# CRYSTAL LAKE SUPPORTIVE ENVIRONMENTS

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Attain, Inc.
- **Organization subpart:** No

## Provider details

- **NPI number:** 1932535184
- **Authorized official:** MR. CRAIG COOK PH.D., BCBA-D (EXECUTIVE DIRECTOR)
- **Authorized official phone:** (407) 965-3055

## Contact information

- **Practice address:** 2710 STATEN AVE, SUITE A, ORLANDO, FL 32804-4211
- **Practice address phone:** (407) 965-3018
- **Practice address fax:** (877) 690-2003
- **Mailing address:** 2710 STATEN AVE, SUITE A, ORLANDO, FL 32804-4211
- **Mailing address phone:** (407) 965-3018
- **Mailing address fax:** (877) 690-2003

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 103K00000X | Behavior Analyst | — | — | Yes |

## Other

- **Enumeration date:** 09/19/2013
- **Last updated:** 11/18/2013

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 671009396 | — | FL |