Provider Demographics
NPI:1235383977
Name:AUTISM SERVICE CENTER OF SAN ANTONIO
Entity Type:Organization
Organization Name:AUTISM SERVICE CENTER OF SAN ANTONIO
Other - Org Name:AUTISM COMMUNITY NETWORK
Other - Org Type:Doing Business As
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:JESSICA
Authorized Official - Middle Name:H
Authorized Official - Last Name:FRANCO
Authorized Official - Suffix:
Authorized Official - Credentials:PHD,CCC-SLP,BCBA
Authorized Official - Phone:210-435-1000
Mailing Address - Street 1:701 S ZARZAMORA ST
Mailing Address - Street 2:COTTAGE #1
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78207-5209
Mailing Address - Country:US
Mailing Address - Phone:210-435-1000
Mailing Address - Fax:210-200-6056
Practice Address - Street 1:701 S ZARZAMORA ST
Practice Address - Street 2:COTTAGE #1
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78207-5209
Practice Address - Country:US
Practice Address - Phone:210-435-1000
Practice Address - Fax:210-200-6056
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-11-07
Last Update Date:2009-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1-02-0778103K00000X
PENDING225X00000X
TX19168235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Multi-Specialty
No103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Multi-Specialty
No225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGroup - Multi-Specialty