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NPI Code Detail

MEDICARE: CENTER FOR AUTISM AND RELATED DISORDERS LLC

MEDICARE: CENTER FOR AUTISM AND RELATED DISORDERS 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
1252Y00000XEarly Intervention Provider Agency
2103K00000XBehavior Analyst

General Provider Information

NPI Number : 1669651675
Entity Type Code : Organization
Provider Name (Legal Business Name) : CENTER FOR AUTISM AND RELATED DISORDERS LLC
Provider Business Mailing Address
First Line : 5850 GRANITE PKWY STE 600
Second Line :
City : PLANO
State : TX
Zip : 75024-6753
Country : US
Telephone Number : 818-345-2345
Fax Number : 818-758-8015
Provider Business Practice Location Address
First Line : 5850 GRANITE PKWY STE 600
Second Line :
City : PLANO
State : TX
Zip : 75024-6753
Country : US
Telephone Number : 817-908-5992
Fax Number : 818-758-8015
Authorized Official
Title or Position : CEO
Name : JENNIFER WEBSTER
Credential :
Telephone Number : 818-345-2345
Provider Enumeration Date : 10/25/2007
Last Update Date : 12/01/2022

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Directions to “CENTER FOR AUTISM AND RELATED DISORDERS LLC ” Practice Location

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