Provider Demographics
NPI:1184862609
Name:EARLY EDUCATION CENTER FOR AUTISM (EECA)
Entity Type:Organization
Organization Name:EARLY EDUCATION CENTER FOR AUTISM (EECA)
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINICAL DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:SHANNON
Authorized Official - Middle Name:RAE
Authorized Official - Last Name:RODRIGUE
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:951-699-9000
Mailing Address - Street 1:27403 YNEZ RD STE 206
Mailing Address - Street 2:
Mailing Address - City:TEMECULA
Mailing Address - State:CA
Mailing Address - Zip Code:92591-4616
Mailing Address - Country:US
Mailing Address - Phone:951-699-9000
Mailing Address - Fax:
Practice Address - Street 1:27403 YNEZ RD STE 206
Practice Address - Street 2:
Practice Address - City:TEMECULA
Practice Address - State:CA
Practice Address - Zip Code:92591-4616
Practice Address - Country:US
Practice Address - Phone:951-699-9000
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-01-22
Last Update Date:2009-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health