Healthcare Provider Details

I. General information

NPI: 1528359353
Provider Name (Legal Business Name): AUTISM SERVICES FOR KIDS, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/27/2011
Last Update Date: 06/02/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2623 PRINCETON RD
CLEVELAND HEIGHTS OH
44118-4313
US

IV. Provider business mailing address

2623 PRINCETON RD
CLEVELAND HEIGHTS OH
44118-4313
US

V. Phone/Fax

Practice location:
  • Phone: 216-233-4231
  • Fax:
Mailing address:
  • Phone: 216-233-4231
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code252Y00000X
TaxonomyEarly Intervention Provider Agency
License Number
License Number State
# 4
Primary TaxonomyY
Taxonomy Code251C00000X
TaxonomyDevelopmentally Disabled Services Day Training Agency
License Number
License Number State

VIII. Authorized Official

Name: KATE VANDERPLOUGH
Title or Position: BEHAVIOR CONSULTANT
Credential:
Phone: 216-233-4231