Healthcare Provider Details

I. General information

NPI: 1730949884
Provider Name (Legal Business Name): THE CORPORATION FOR AUTISM SERVICES DEVELOPMENT AND GROWTH, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/19/2024
Last Update Date: 03/19/2024
Certification Date: 03/19/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

20 S MAIN ST
RITTMAN OH
44270-1438
US

IV. Provider business mailing address

13942 HATFIELD RD
RITTMAN OH
44270-9526
US

V. Phone/Fax

Practice location:
  • Phone: 330-347-0271
  • Fax:
Mailing address:
  • Phone: 330-347-0271
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QX0100X
TaxonomyOccupational Medicine Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: JASON MEADE
Title or Position: CEO
Credential: MHSA
Phone: 330-347-0271