Healthcare Provider Details

I. General information

NPI: 1427742915
Provider Name (Legal Business Name): GLOBAL CENTER FOR AUTISM SERVICES, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/07/2023
Last Update Date: 01/27/2025
Certification Date: 01/27/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4421 NICOLE DR
LANHAM MD
20706-4352
US

IV. Provider business mailing address

4485 FORBES BLVD
LANHAM MD
20706-4354
US

V. Phone/Fax

Practice location:
  • Phone: 301-909-9766
  • Fax:
Mailing address:
  • Phone: 301-429-2900
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2081P0010X
TaxonomyPediatric Rehabilitation Medicine Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code225XP0200X
TaxonomyPediatric Occupational Therapist
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number
License Number State

VIII. Authorized Official

Name: SALVADOR TAN
Title or Position: EXECUTIVE DIRECTOR
Credential:
Phone: 301-429-2900