| Nac Opco Llc | |
|
152 Burnetts Way Suffolk VA 23434-8166 | |
| (480) 634-3326 | |
| Not Available |
| Full Name | Nac Opco Llc |
|---|---|
| Speciality | Behavior Analyst |
| Location | 152 Burnetts Way, Suffolk, Virginia |
| Authorized Official Name and Position | Justin Lane Hartman (CEO) |
| Authorized Official Contact | 4806343326 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Nac Opco Llc 6 Whisper Ln Suffern NY 10901-4023 Ph: (480) 634-3326 | Nac Opco Llc 152 Burnetts Way Suffolk VA 23434-8166 Ph: (480) 634-3326 |
| NPI Number | 1972353738 |
|---|---|
| Provider Enumeration Date | 03/25/2024 |
| Last Update Date | 03/25/2024 |
| Certification Date | 03/25/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1972353738 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103K00000X | Behavior Analyst | (* (Not Available)) | Primary |
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