Healthcare Provider Details

I. General information

NPI: 1154070100
Provider Name (Legal Business Name): JAVA AUTISM SERVICES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/18/2022
Last Update Date: 07/13/2026
Certification Date: 07/13/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2970 N LITCHFIELD RD STE 110
GOODYEAR AZ
85395-7831
US

IV. Provider business mailing address

2970 N LITCHFIELD RD STE 110
GOODYEAR AZ
85395-7831
US

V. Phone/Fax

Practice location:
  • Phone: 480-769-5302
  • Fax:
Mailing address:
  • Phone: 480-763-5302
  • Fax: 480-769-5378

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number
License Number State

VIII. Authorized Official

Name: YOSEF SCHUCK
Title or Position: OWNER
Credential:
Phone: 615-861-9786