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NPI Code Detail

MEDICARE: AUTISM SPECTRUM THERAPIES, LLC

MEDICARE: AUTISM SPECTRUM THERAPIES, 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
1251S00000XCommunity/Behavioral Health Agency
2252Y00000XEarly Intervention Provider Agency
3103K00000XBehavior Analyst

General Provider Information

NPI Number : 1609194000
Entity Type Code : Organization
Provider Name (Legal Business Name) : AUTISM SPECTRUM THERAPIES, LLC
Provider Business Mailing Address
First Line : 2550 N HOLLYWOOD WAY STE 301
Second Line :
City : BURBANK
State : CA
Zip : 91505-5025
Country : US
Telephone Number : 866-727-8274
Fax Number : 747-220-0012
Provider Business Practice Location Address
First Line : 2550 N HOLLYWOOD WAY STE 301
Second Line :
City : BURBANK
State : CA
Zip : 91505-5025
Country : US
Telephone Number : 866-727-8274
Fax Number : 800-459-4245
Authorized Official
Title or Position : EXECUTIVE VP, AUTISM SERVICES
Name : ROBERT HAUPT
Credential :
Telephone Number : 866-727-8274
Provider Enumeration Date : 05/10/2010
Last Update Date : 04/10/2024

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Directions to “AUTISM SPECTRUM THERAPIES, LLC ” Practice Location

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