Provider Demographics
NPI:1619278470
Name:AUTISM NORTH
Entity Type:Organization
Organization Name:AUTISM NORTH
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:PAUL
Authorized Official - Middle Name:
Authorized Official - Last Name:ESCHBACH
Authorized Official - Suffix:
Authorized Official - Credentials:MA, BCBA
Authorized Official - Phone:800-306-8602
Mailing Address - Street 1:12 VAN GOGH DR
Mailing Address - Street 2:
Mailing Address - City:EAST WINDSOR
Mailing Address - State:NJ
Mailing Address - Zip Code:08520-2999
Mailing Address - Country:US
Mailing Address - Phone:609-721-2227
Mailing Address - Fax:
Practice Address - Street 1:12 VAN GOGH DR
Practice Address - Street 2:
Practice Address - City:EAST WINDSOR
Practice Address - State:NJ
Practice Address - Zip Code:08520-2999
Practice Address - Country:US
Practice Address - Phone:609-721-2227
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:TRI CARE
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2010-11-10
Last Update Date:2010-11-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management