Organization
AUTISM LIVING EXPERIENCE OF NORTH CAROLINA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. TODD C STUCKEY (CFO)
(443) 838-9065
Entity
Organization
Contact information
Practice address
875 RAYS BRIDGE RD, WHISPERING PINES, NC 28327-5910
(253) 278-7439
Mailing address
6700 ALEXANDER BELL DR STE 253, COLUMBIA, MD 21046-2122
(443) 838-9065
(443) 276-6720
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
—
—
106S00000X
Behavior Technician
—
—
251S00000X
Community/Behavioral Health Agency
—
—
Other
Enumeration date
01/21/2022
Last updated
05/05/2022
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