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NPI Code Detail

MEDICARE: CENTER FOR AUTISM & BEHAVIOR ANALYSIS, LLC

MEDICARE: CENTER FOR AUTISM & BEHAVIOR ANALYSIS, LLC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1103K00000XBehavior Analyst
22080P0006XDevelopmental - Behavioral Pediatrics Physician
3251S00000XCommunity/Behavioral Health Agency

General Provider Information

NPI Number : 1447600143
Entity Type Code : Organization
Provider Name (Legal Business Name) : CENTER FOR AUTISM & BEHAVIOR ANALYSIS, LLC
Provider Business Mailing Address
First Line : 7160 RAFAEL RIVERA WAY STE 110
Second Line :
City : LAS VEGAS
State : NV
Zip : 89113-5394
Country : US
Telephone Number : 702-850-2691
Fax Number : 888-531-2315
Provider Business Practice Location Address
First Line : 7160 RAFAEL RIVERA WAY STE 110
Second Line :
City : LAS VEGAS
State : NV
Zip : 89113-5394
Country : US
Telephone Number : 702-850-2691
Fax Number : 888-531-2315
Authorized Official
Title or Position : EXECUTIVE DIRECTOR
Name : DARNELL THOMPKINS
Credential :
Telephone Number : 702-850-2691
Provider Enumeration Date : 06/14/2016
Last Update Date : 12/27/2023

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