Provider Demographics
NPI:1124558879
Name:CHILDREN'S AUTISM CENTER, LLC
Entity Type:Organization
Organization Name:CHILDREN'S AUTISM CENTER, LLC
Other - Org Name:CAC NEW ORLEANS
Other - Org Type:Other Name
Authorized Official - Title/Position:BILLING MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:DEBORAH
Authorized Official - Middle Name:
Authorized Official - Last Name:HACKNEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:512-733-2800
Mailing Address - Street 1:1516 E PALM VALLEY BLVD BLDG C
Mailing Address - Street 2:
Mailing Address - City:ROUND ROCK
Mailing Address - State:TX
Mailing Address - Zip Code:78664-4619
Mailing Address - Country:US
Mailing Address - Phone:512-733-2800
Mailing Address - Fax:512-310-5697
Practice Address - Street 1:1215 PRYTANIA ST
Practice Address - Street 2:
Practice Address - City:NEW ORLEANS
Practice Address - State:LA
Practice Address - Zip Code:70130-4357
Practice Address - Country:US
Practice Address - Phone:512-733-2800
Practice Address - Fax:512-310-5697
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-06-15
Last Update Date:2017-06-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Single Specialty