Provider Demographics
NPI:1194389304
Name:AUTISM THERAPY & TRAINING SERVICES
Entity Type:Organization
Organization Name:AUTISM THERAPY & TRAINING SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OPERATION MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:LOICE
Authorized Official - Middle Name:
Authorized Official - Last Name:GICHUKI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:781-513-0224
Mailing Address - Street 1:1 LONGWOOD AVE
Mailing Address - Street 2:
Mailing Address - City:WORCESTER
Mailing Address - State:MA
Mailing Address - Zip Code:01606-3416
Mailing Address - Country:US
Mailing Address - Phone:781-513-0224
Mailing Address - Fax:
Practice Address - Street 1:1 LONGWOOD AVE
Practice Address - Street 2:
Practice Address - City:WORCESTER
Practice Address - State:MA
Practice Address - Zip Code:01606-3416
Practice Address - Country:US
Practice Address - Phone:781-513-0224
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-04-24
Last Update Date:2019-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health