Organization
ATAP 4 AUTISM INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LATEONYA JENKINS BS (MEMBER)
(252) 572-2933
Entity
Organization
Contact information
Practice address
120 E BELLE ST, HENDERSON, NC 27536-4502
(252) 572-2933
(877) 352-0133
Mailing address
PO BOX 1325, MORRISVILLE, NC 27560-1325
(252) 572-2933
(877) 352-0133
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
—
—
251B00000X
Case Management Agency
—
—
251C00000X
Developmentally Disabled Services Day Training Agency
—
—
251S00000X
Community/Behavioral Health Agency
Primary
—
—
261QD1600X
Developmental Disabilities Clinic/Center
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
14639688
CAQH
CO
Enumeration date
04/15/2021
Last updated
07/20/2022
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