Healthcare Provider Details

I. General information

NPI: 1154883247
Provider Name (Legal Business Name): PROJECT HOPE AUTISM SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/05/2019
Last Update Date: 04/05/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1701 MILITARY TRL STE 142
JUPITER FL
33458-6325
US

IV. Provider business mailing address

1701 MILITARY TRL STE 142
JUPITER FL
33458-6325
US

V. Phone/Fax

Practice location:
  • Phone: 561-242-1725
  • Fax: 561-242-1726
Mailing address:
  • Phone: 561-242-1725
  • Fax: 561-242-1726

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code106E00000X
TaxonomyAssistant Behavior Analyst
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number
License Number State

VIII. Authorized Official

Name: DEBORAH COLLINS
Title or Position: OWNER
Credential: ARNP
Phone: 561-242-1725