Provider Demographics
NPI:1003112939
Name:AUTISM BEHAVIORAL SOLUTIONS LLC
Entity Type:Organization
Organization Name:AUTISM BEHAVIORAL SOLUTIONS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:DELISA
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:DEAVENPORT
Authorized Official - Suffix:
Authorized Official - Credentials:MA
Authorized Official - Phone:806-206-5813
Mailing Address - Street 1:3726 W AMARILLO BLVD
Mailing Address - Street 2:
Mailing Address - City:AMARILLO
Mailing Address - State:TX
Mailing Address - Zip Code:79106-7021
Mailing Address - Country:US
Mailing Address - Phone:806-342-3338
Mailing Address - Fax:806-359-2959
Practice Address - Street 1:3726 W AMARILLO BLVD
Practice Address - Street 2:
Practice Address - City:AMARILLO
Practice Address - State:TX
Practice Address - Zip Code:79106-7021
Practice Address - Country:US
Practice Address - Phone:806-342-3338
Practice Address - Fax:806-359-2959
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-02-10
Last Update Date:2011-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Single Specialty