NPIMap

Organization Active NPI

Southeast Alabama Autism Center

  • Behavior Analyst
  • Enterprise, AL
National Provider Identifier
1245653989
Registry record updated Jan 31, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior AnalystTaxonomy code 103K00000X
License
1-06-2863 Issued in FL
Legal business name
SOUTHEAST ALABAMA AUTISM CENTER
Practice address
210 E Grubbs St
Suite 1
Enterprise, AL 36330-2646
Phone
(334) 360-1158
NPI assigned
Jan 31, 2014
Last updated
Jan 31, 2014By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 31, 2014

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Nicole SlayNPI 1316171804
Title
Bcba
Phone
(334) 360-1158

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior Analyst 103K00000X 1-06-2863 FL Primary

Addresses

Primary practice location

210 E Grubbs St
Suite 1
Enterprise, AL 36330-2646

Mailing address

1871 Highway 2
Westville, FL 32464-3025
Phone (334) 360-1158

National Provider Directory

National Provider Directory

Locations

210 E Grubbs St
Ste 1
Enterprise, AL 36330
Phone (334) 360-1158

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1391126400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1391126400000",
    "number": "1245653989",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1871 HIGHWAY 2",
            "city": "WESTVILLE",
            "state": "FL",
            "postal_code": "324643025",
            "telephone_number": "334-360-1158",
            "fax_number": "334-694-5191"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "210 E GRUBBS ST",
            "address_2": "SUITE 1",
            "city": "ENTERPRISE",
            "state": "AL",
            "postal_code": "363302646",
            "telephone_number": "334-360-1158"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTHEAST ALABAMA AUTISM CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-01-31",
        "last_updated": "2014-01-31",
        "status": "A",
        "authorized_official_last_name": "SLAY",
        "authorized_official_first_name": "NICOLE",
        "authorized_official_title_or_position": "BCBA",
        "authorized_official_telephone_number": "334-360-1158"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "FL",
            "license": "1-06-2863",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Enterprise, AL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 31, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.