Provider Demographics
NPI:1275132458
Name:AUTISM BEHAVIORAL & THERAPEUTIC SERVICES
Entity Type:Organization
Organization Name:AUTISM BEHAVIORAL & THERAPEUTIC SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:RN BSN
Authorized Official - Prefix:
Authorized Official - First Name:ELIZABETH
Authorized Official - Middle Name:
Authorized Official - Last Name:CIERA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:774-232-4975
Mailing Address - Street 1:5 BEDFORD AVE
Mailing Address - Street 2:
Mailing Address - City:WORCESTER
Mailing Address - State:MA
Mailing Address - Zip Code:01604-4707
Mailing Address - Country:US
Mailing Address - Phone:774-232-4975
Mailing Address - Fax:
Practice Address - Street 1:5 BEDFORD AVE
Practice Address - Street 2:
Practice Address - City:WORCESTER
Practice Address - State:MA
Practice Address - Zip Code:01604-4707
Practice Address - Country:US
Practice Address - Phone:774-232-4975
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-10-20
Last Update Date:2020-10-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health