Provider Demographics
NPI:1558704114
Name:A HOPE FOR AUTISM FOUNDATION
Entity Type:Organization
Organization Name:A HOPE FOR AUTISM FOUNDATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:ROBBIN
Authorized Official - Middle Name:JO
Authorized Official - Last Name:SOBOTKA-SOLES
Authorized Official - Suffix:
Authorized Official - Credentials:BCABA
Authorized Official - Phone:503-516-9085
Mailing Address - Street 1:PO BOX 12061
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97212-0061
Mailing Address - Country:US
Mailing Address - Phone:503-516-9085
Mailing Address - Fax:
Practice Address - Street 1:733 NE PRESCOTT ST
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97211-3967
Practice Address - Country:US
Practice Address - Phone:503-516-9085
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-04-14
Last Update Date:2013-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OR0-08-2429OtherBCABA
OR1-10-6754OtherBCBA