Provider Demographics
NPI:1417694837
Name:O'S CLUBHOUSE FOR AUTISM INC.
Entity Type:Organization
Organization Name:O'S CLUBHOUSE FOR AUTISM INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:REBECCA
Authorized Official - Middle Name:LOUISE
Authorized Official - Last Name:WILLIAMS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:989-860-1693
Mailing Address - Street 1:6137 TITTABAWASSEE RD STE 1
Mailing Address - Street 2:
Mailing Address - City:SAGINAW
Mailing Address - State:MI
Mailing Address - Zip Code:48603-9627
Mailing Address - Country:US
Mailing Address - Phone:989-860-1693
Mailing Address - Fax:
Practice Address - Street 1:6137 TITTABAWASSEE RD STE 1
Practice Address - Street 2:
Practice Address - City:SAGINAW
Practice Address - State:MI
Practice Address - Zip Code:48603-9627
Practice Address - Country:US
Practice Address - Phone:989-860-1693
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-05-17
Last Update Date:2022-05-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior TechnicianGroup - Single Specialty