Provider Demographics
NPI:1336506351
Name:CENTER FOR AUTISM REHABILITATION AND EVALUATION, LLC
Entity Type:Organization
Organization Name:CENTER FOR AUTISM REHABILITATION AND EVALUATION, LLC
Other - Org Name:C.A.R.E.
Other - Org Type:Other Name
Authorized Official - Title/Position:FOUNDER
Authorized Official - Prefix:
Authorized Official - First Name:CHRISTOPHER
Authorized Official - Middle Name:JON
Authorized Official - Last Name:ROBERTS
Authorized Official - Suffix:
Authorized Official - Credentials:BCBA
Authorized Official - Phone:425-902-6248
Mailing Address - Street 1:1600 DEXTER AVE. N.
Mailing Address - Street 2:SUITE D1
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98109-6655
Mailing Address - Country:US
Mailing Address - Phone:425-902-6248
Mailing Address - Fax:
Practice Address - Street 1:1600 DEXTER AVE N
Practice Address - Street 2:SUITE D1
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98109-3079
Practice Address - Country:US
Practice Address - Phone:425-902-6248
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-01-21
Last Update Date:2017-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORABABB10174018251S00000X
WA200357251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health