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NPI Code Detail

MEDICARE: AUTISTIC TREATMENT CENTER, INC.

MEDICARE: AUTISTIC TREATMENT CENTER, INC.
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
1261QM1300XMulti-Specialty Clinic/Center
2261QR0400XRehabilitation Clinic/Center

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1740207422
Entity Type Code : Organization
Provider Name (Legal Business Name) : AUTISTIC TREATMENT CENTER, INC.
Provider Business Mailing Address
First Line : 10503 METRIC DR
Second Line :
City : DALLAS
State : TX
Zip : 75243-5514
Country : US
Telephone Number : 972-644-2076
Fax Number : 972-644-5650
Provider Business Practice Location Address
First Line : 15911 NACOGDOCHES RD
Second Line :
City : SAN ANTONIO
State : TX
Zip : 78247-1107
Country : US
Telephone Number : 210-599-7733
Fax Number : 210-599-3105
Authorized Official
Title or Position : PRESIDENT/CEO
Name : ANNA PENN HUNDLEY
Credential :
Telephone Number : 972-644-2076
Provider Enumeration Date : 07/17/2006
Last Update Date : 11/22/2010

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Directions to “AUTISTIC TREATMENT CENTER, INC. ” Practice Location

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