Provider Demographics
NPI:1427559798
Name:AUTISM COMMUNITY SUPPORTS LLC
Entity Type:Organization
Organization Name:AUTISM COMMUNITY SUPPORTS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:TINA
Authorized Official - Middle Name:
Authorized Official - Last Name:DOBSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:719-217-1134
Mailing Address - Street 1:10001 EAST EVANS AVE
Mailing Address - Street 2:90A
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80247-3557
Mailing Address - Country:US
Mailing Address - Phone:719-217-1134
Mailing Address - Fax:
Practice Address - Street 1:10001 EAST EVANS AVE
Practice Address - Street 2:90A
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80247-3557
Practice Address - Country:US
Practice Address - Phone:719-217-1134
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-02-22
Last Update Date:2021-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes385H00000XRespite Care FacilityRespite Care
No373H00000XNursing Service Related ProvidersDay Training/Habilitation SpecialistGroup - Multi-Specialty
No376J00000XNursing Service Related ProvidersHomemakerGroup - Multi-Specialty