Provider Demographics
NPI:1598030819
Name:AUTISM LEARNING CENTER, INC.
Entity Type:Organization
Organization Name:AUTISM LEARNING CENTER, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:PAUL
Authorized Official - Middle Name:
Authorized Official - Last Name:GLASS
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:703-506-1930
Mailing Address - Street 1:7600 LEESBURG PIKE
Mailing Address - Street 2:SUITE 410
Mailing Address - City:FALLS CHURCH
Mailing Address - State:VA
Mailing Address - Zip Code:22043-2004
Mailing Address - Country:US
Mailing Address - Phone:703-506-1930
Mailing Address - Fax:703-506-1920
Practice Address - Street 1:7600 LEESBURG PIKE
Practice Address - Street 2:SUITE 410
Practice Address - City:FALLS CHURCH
Practice Address - State:VA
Practice Address - Zip Code:22043-2004
Practice Address - Country:US
Practice Address - Phone:703-506-1930
Practice Address - Fax:703-506-1920
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-03-20
Last Update Date:2012-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Single Specialty