Provider Demographics
NPI:1063676344
Name:ASSOCIATION FOR METROAREA AUTISTIC CHILDREN, INC.
Entity Type:Organization
Organization Name:ASSOCIATION FOR METROAREA AUTISTIC CHILDREN, INC.
Other - Org Name:AMAC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:BONNIE
Authorized Official - Middle Name:
Authorized Official - Last Name:MOSES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:212-645-5005
Mailing Address - Street 1:25 W 17TH ST
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10011-5501
Mailing Address - Country:US
Mailing Address - Phone:212-645-5005
Mailing Address - Fax:212-645-0170
Practice Address - Street 1:25 W 17TH ST
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10011-5501
Practice Address - Country:US
Practice Address - Phone:212-645-5005
Practice Address - Fax:212-645-0170
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-07-15
Last Update Date:2015-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY251B00000X, 251C00000X, 320900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251C00000XAgenciesDay Training, Developmentally Disabled Services
No251B00000XAgenciesCase Management
No320900000XResidential Treatment FacilitiesCommunity Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY03739264Medicaid
NY02253932Medicaid
NY01995697Medicaid
NY02692428Medicaid