Provider Demographics
NPI:1073286654
Name:AUTISM BEHAVIOR AND COGNITIVE DEVELOPMENT LLC
Entity Type:Organization
Organization Name:AUTISM BEHAVIOR AND COGNITIVE DEVELOPMENT LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO & FOUNDER
Authorized Official - Prefix:
Authorized Official - First Name:KHALED
Authorized Official - Middle Name:
Authorized Official - Last Name:KHAMIS
Authorized Official - Suffix:
Authorized Official - Credentials:BCBA, LBA
Authorized Official - Phone:334-524-1897
Mailing Address - Street 1:24253 ALYDAR LOOP
Mailing Address - Street 2:
Mailing Address - City:DAPHNE
Mailing Address - State:AL
Mailing Address - Zip Code:36526-0330
Mailing Address - Country:US
Mailing Address - Phone:334-524-1897
Mailing Address - Fax:
Practice Address - Street 1:24253 ALYDAR LOOP
Practice Address - Street 2:
Practice Address - City:DAPHNE
Practice Address - State:AL
Practice Address - Zip Code:36526-0330
Practice Address - Country:US
Practice Address - Phone:334-524-1897
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-07-29
Last Update Date:2021-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health