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NPI Code Detail

MEDICARE: ALEXANDER LEIGH CENTER FOR AUTISM

MEDICARE: ALEXANDER LEIGH CENTER FOR AUTISM
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1251S00000XCommunity/Behavioral Health Agency

General Provider Information

NPI Number : 1366692279
Entity Type Code : Organization
Provider Name (Legal Business Name) : ALEXANDER LEIGH CENTER FOR AUTISM
Provider Business Mailing Address
First Line : 9109 TRINITY DR
Second Line :
City : LAKE IN THE HILLS
State : IL
Zip : 60156-1668
Country : US
Telephone Number : 847-458-6802
Fax Number :
Provider Business Practice Location Address
First Line : 9109 TRINITY DR
Second Line :
City : LAKE IN THE HILLS
State : IL
Zip : 60156-1668
Country : US
Telephone Number : 847-458-6802
Fax Number :
Authorized Official
Title or Position : CHAIR
Name : DORIE HOEVEL
Credential :
Telephone Number : 847-458-6802
Provider Enumeration Date : 09/27/2008
Last Update Date : 09/27/2008

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Directions to “ALEXANDER LEIGH CENTER FOR AUTISM ” Practice Location

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