Healthcare Provider Details

I. General information

NPI: 1194094110
Provider Name (Legal Business Name): AUTISM PARENT CARE, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/20/2011
Last Update Date: 11/21/2024
Certification Date: 11/21/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12354 HANCOCK ST
CARMEL IN
46032-5807
US

IV. Provider business mailing address

664 DOGWOOD CT
NOBLESVILLE IN
46062
US

V. Phone/Fax

Practice location:
  • Phone: 317-503-1296
  • Fax:
Mailing address:
  • Phone: 317-503-1296
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number1-11-8855
License Number StateIN

VIII. Authorized Official

Name: DR. JANE R YIP
Title or Position: CLINICAL DIRECTOR
Credential: PHD
Phone: 317-503-1296