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NPI Code Detail

MEDICARE: EARLY AUTISM PROJECT, INC.

MEDICARE: EARLY AUTISM PROJECT, INC.
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
1103K00000XBehavior Analyst

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1417477175
Entity Type Code : Organization
Provider Name (Legal Business Name) : EARLY AUTISM PROJECT, INC.
Provider Business Mailing Address
First Line : PO BOX 931142
Second Line :
City : ATLANTA
State : GA
Zip : 31193-1142
Country : US
Telephone Number : 615-696-6761
Fax Number : 615-880-5782
Provider Business Practice Location Address
First Line : 1345 COMPANION CT
Second Line :
City : SUMTER
State : SC
Zip : 29150-1749
Country : US
Telephone Number : 615-569-1314
Fax Number : 615-577-5654
Authorized Official
Title or Position : REVENUE CYCLE MANAGER
Name : JESSICA KIRK
Credential :
Telephone Number : 615-880-5782
Provider Enumeration Date : 06/23/2017
Last Update Date : 09/19/2023

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Directions to “EARLY AUTISM PROJECT, INC. ” Practice Location

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