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General NPI Number Information
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NPI Number | 1023453701
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Entity Type | Organization
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Legal Business Name | AUTISM BEHAVIOR CONSULTING GROUP, INC
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Dates
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Enumeration Date | 05/07/2013
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Last Update Date | 05/07/2013
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Provider Practice Location Address
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Address Line | 99-950 IWAENA ST FL 2
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City | AIEA
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State | HI
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Zip | 96701-5645
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Country | US
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Telephone | 808-277-7736
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Fax | 808-748-0202
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Provider Business Mailing Address
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Address Line | 99-950 IWAENA ST FL 2
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City | AIEA
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State | HI
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Zip | 96701-5645
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Country | US
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Telephone | 808-277-7736
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Fax | 808-748-0202
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Authorized Official
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Title or Position | CEO/FOUNDER
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Name | MRS. AMY WIECH
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Credential |
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Telephone | 808-277-7736
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number | 0-12-5053
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License Number State | HI
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