Provider Demographics
NPI:1477916005
Name:MORGAN AUTISM CENTER
Entity Type:Organization
Organization Name:MORGAN AUTISM CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:FLORENCE
Authorized Official - Middle Name:
Authorized Official - Last Name:FULLER
Authorized Official - Suffix:
Authorized Official - Credentials:MFT
Authorized Official - Phone:408-241-8161
Mailing Address - Street 1:2280 KENWOOD AVE
Mailing Address - Street 2:
Mailing Address - City:SAN JOSE
Mailing Address - State:CA
Mailing Address - Zip Code:95128-1332
Mailing Address - Country:US
Mailing Address - Phone:408-241-8161
Mailing Address - Fax:408-241-8231
Practice Address - Street 1:2280 KENWOOD AVE
Practice Address - Street 2:
Practice Address - City:SAN JOSE
Practice Address - State:CA
Practice Address - Zip Code:95128-1332
Practice Address - Country:US
Practice Address - Phone:408-241-8161
Practice Address - Fax:408-241-8231
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-03-31
Last Update Date:2016-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA436979363251300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251300000XAgenciesLocal Education Agency (LEA)