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General NPI Number Information
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NPI Number | 1760746838
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Entity Type | Organization
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Legal Business Name | AUTISTIC SUPPORT SERVICES, LLC
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Dates
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Enumeration Date | 07/03/2012
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Last Update Date | 07/03/2012
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Provider Practice Location Address
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Address Line | 3910 LORCOM LN
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City | ARLINGTON
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State | VA
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Zip | 22207-5130
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Country | US
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Telephone | 703-525-8210
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 7471
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City | ARLINGTON
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State | VA
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Zip | 22207-0471
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OWNER/CEO
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Name | MRS. KATHERINE MCCLAIN
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Credential |
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Telephone | 202-550-7785
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251C00000X
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Taxonomy Name | Developmentally Disabled Services Day Training Agency
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License Number |
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License Number State |
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