Provider Demographics
NPI:1225498348
Name:GRANT A GIFT AUTISM FOUNDATION
Entity Type:Organization
Organization Name:GRANT A GIFT AUTISM FOUNDATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:LYNDA
Authorized Official - Middle Name:
Authorized Official - Last Name:TACHE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:702-564-2453
Mailing Address - Street 1:630 S RANCHO DR
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89106-4873
Mailing Address - Country:US
Mailing Address - Phone:702-564-2453
Mailing Address - Fax:702-527-5353
Practice Address - Street 1:630 S RANCHO DR
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89106-4873
Practice Address - Country:US
Practice Address - Phone:702-564-2453
Practice Address - Fax:702-527-5353
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-03-02
Last Update Date:2016-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV0-14-5003103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Multi-Specialty