MEDICARE: AUTISM FAMILY SERVICES OF BEAUMONT LLC

Medicare Provider Information

Scope of Practice

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

#	Taxonomy Code	Taxonomy
1	253Z00000X	In Home Supportive Care Agency
2	261QM1300X	Multi-Specialty Clinic/Center
3	171M00000X	Case Manager/Care Coordinator
4	385HR2060X	Child Intellectual and/or Developmental Disabilities Respite Care
5	261QD1600X	Developmental Disabilities Clinic/Center
6	101YP2500X	Professional Counselor
7	106H00000X	Marriage & Family Therapist
8	106S00000X	Behavior Technician
9	103K00000X	Behavior Analyst

General Provider Information

NPI Number	:	1710643861
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	AUTISM FAMILY SERVICES OF BEAUMONT LLC

Provider Business Mailing Address
First Line	:	6642 PHELAN BLVD
Second Line	:
City	:	BEAUMONT
State	:	TX
Zip	:	77706-5966
Country	:	US
Telephone Number	:	409-242-1559
Fax Number	:	409-242-1558

Provider Business Practice Location Address
First Line	:	6642 PHELAN BLVD
Second Line	:
City	:	BEAUMONT
State	:	TX
Zip	:	77706-5966
Country	:	US
Telephone Number	:	409-893-7993
Fax Number	:	409-299-9551

Authorized Official
Title or Position	:	CLINIC DIRECTOR
Name	:	JENNIFER LYN RAMIREZ
Credential	:	LBA, LPC
Telephone Number	:	409-242-1559

Provider Enumeration Date	:	11/12/2021
Last Update Date	:	09/22/2025

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