Provider Demographics
NPI:1508462276
Name:AUTISM BEHAVIOR CONSULTANTS OF THE WEST
Entity Type:Organization
Organization Name:AUTISM BEHAVIOR CONSULTANTS OF THE WEST
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:MICHELLE
Authorized Official - Middle Name:
Authorized Official - Last Name:ROSSLER
Authorized Official - Suffix:
Authorized Official - Credentials:MS, CCC-SLP
Authorized Official - Phone:505-728-9885
Mailing Address - Street 1:1118 VALLEY VIEW DR SW
Mailing Address - Street 2:
Mailing Address - City:LOS LUNAS
Mailing Address - State:NM
Mailing Address - Zip Code:87031-6143
Mailing Address - Country:US
Mailing Address - Phone:505-728-9885
Mailing Address - Fax:
Practice Address - Street 1:1118 VALLEY VIEW DR SW
Practice Address - Street 2:
Practice Address - City:LOS LUNAS
Practice Address - State:NM
Practice Address - Zip Code:87031-6143
Practice Address - Country:US
Practice Address - Phone:505-728-9885
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-12-08
Last Update Date:2020-12-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251C00000XAgenciesDay Training, Developmentally Disabled Services