Provider Demographics
NPI:1639435563
Name:AUTISM BRIGHT START
Entity Type:Organization
Organization Name:AUTISM BRIGHT START
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:SARAH
Authorized Official - Middle Name:NICOLE
Authorized Official - Last Name:HIVELY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:770-880-8002
Mailing Address - Street 1:233 S WACKER DR
Mailing Address - Street 2:84TH FLOOR
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60606-6306
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:233 S WACKER DR
Practice Address - Street 2:84TH FLOOR
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60606-6306
Practice Address - Country:US
Practice Address - Phone:770-880-8002
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-04-04
Last Update Date:2012-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Single Specialty