Provider Demographics
NPI:1538639810
Name:KEY AUTISM SERVICES
Entity Type:Organization
Organization Name:KEY AUTISM SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:REGISTERED BEHAVIOR THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:JENIFFER
Authorized Official - Middle Name:
Authorized Official - Last Name:PIMENTEL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:781-952-4887
Mailing Address - Street 1:24 ARCHER ST APT 1
Mailing Address - Street 2:
Mailing Address - City:LYNN
Mailing Address - State:MA
Mailing Address - Zip Code:01902-1203
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:225 CEDAR HILL ST STE 200
Practice Address - Street 2:
Practice Address - City:MARLBOROUGH
Practice Address - State:MA
Practice Address - Zip Code:01752-5900
Practice Address - Country:US
Practice Address - Phone:857-829-4040
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-11-29
Last Update Date:2018-11-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior TechnicianGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
106S00000XOtherBEHAVIOR TECHNICIAN