Healthcare Provider Details
I. General information
NPI: 1639055171
Provider Name (Legal Business Name): SPRING AUTISM KANSAS LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 08/12/2025
Last Update Date: 08/12/2025
Certification Date: 08/04/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
344 ATLANTIC AVE
CEDARHURST NY
11516-1803
US
IV. Provider business mailing address
344 ATLANTIC AVE
CEDARHURST NY
11516-1803
US
V. Phone/Fax
- Phone: 845-269-5991
- Fax:
- Phone: 845-269-5991
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 103K00000X |
| Taxonomy | Behavior Analyst |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
YEHUDA
SCHILLER
Title or Position: MEMBER
Credential:
Phone: 845-269-5991