Provider Demographics
NPI: | 1619737632 |
---|---|
Name: | HEALTH & AUTISM PROFESSIONAL ASSOCIATES & COMPANY, LLC |
Entity Type: | Organization |
Organization Name: | HEALTH & AUTISM PROFESSIONAL ASSOCIATES & COMPANY, LLC |
Other - Org Name: | |
Other - Org Type: | |
Authorized Official - Title/Position: | OWNER |
Authorized Official - Prefix: | MS |
Authorized Official - First Name: | KELCIE |
Authorized Official - Middle Name: | NOELANI |
Authorized Official - Last Name: | RAINES |
Authorized Official - Suffix: | |
Authorized Official - Credentials: | PSYMS, BCBA, LBA |
Authorized Official - Phone: | 808-729-1706 |
Mailing Address - Street 1: | 21191 VINELAND SQ |
Mailing Address - Street 2: | |
Mailing Address - City: | ASHBURN |
Mailing Address - State: | VA |
Mailing Address - Zip Code: | 20147-5463 |
Mailing Address - Country: | US |
Mailing Address - Phone: | 808-729-1706 |
Mailing Address - Fax: | |
Practice Address - Street 1: | 21191 VINELAND SQ |
Practice Address - Street 2: | |
Practice Address - City: | ASHBURN |
Practice Address - State: | VA |
Practice Address - Zip Code: | 20147-5463 |
Practice Address - Country: | US |
Practice Address - Phone: | 808-729-1706 |
Practice Address - Fax: | |
EIN: | <UNAVAIL> |
Is Organization Subpart?: | No |
Parent Organization LBN: | |
Parent Organization TIN: | |
Enumeration Date: | 2024-03-19 |
Last Update Date: | 2024-03-19 |
Deactivation Date: | |
Deactivation Code: | |
Reactivation Date: |
Provider Taxonomies
Primary? | Code | Type | Classification | Specialization | Group |
---|---|---|---|---|---|
Yes | 103K00000X | Behavioral Health & Social Service Providers | Behavior Analyst | Group - Multi-Specialty |