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General NPI Number Information
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NPI Number | 1992961973
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Entity Type | Organization
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Legal Business Name | PHILIPS AUTISM THERAPY CENTER INC
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Dates
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Enumeration Date | 07/30/2008
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Last Update Date | 02/18/2009
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Provider Practice Location Address
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Address Line | 2075 MEADOWLANE AVE
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City | W. MELBOURNE
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State | FL
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Zip | 32904
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Country | US
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Telephone | 888-554-6558
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Fax | 321-757-5177
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Provider Business Mailing Address
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Address Line | 7777 N WICKHAM RD SUITE 12-309
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City | MELBOURNE
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State | FL
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Zip | 32940-7976
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Country | US
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Telephone | 888-554-6558
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Fax | 321-757-5177
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Authorized Official
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Title or Position | OWNER/CEO
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Name | DR. FRANK P DECARO
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Credential | PH.D
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Telephone | 321-432-9418
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP2000X
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Taxonomy Name | Physical Therapy Clinic/Center
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 225X00000X
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Taxonomy Name | Occupational Therapist
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 103K00000X
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Taxonomy Name | Behavior Analyst
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 235Z00000X
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Taxonomy Name | Speech-Language Pathologist
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License Number |
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License Number State | FL
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