Provider Demographics
NPI:1639730294
Name:TRI-CITY AUTISM CENTER, LLC
Entity Type:Organization
Organization Name:TRI-CITY AUTISM CENTER, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MEGHAN
Authorized Official - Middle Name:
Authorized Official - Last Name:NAUCK
Authorized Official - Suffix:
Authorized Official - Credentials:BCBA
Authorized Official - Phone:254-265-6200
Mailing Address - Street 1:5800 LUXOR DR
Mailing Address - Street 2:
Mailing Address - City:KILLEEN
Mailing Address - State:TX
Mailing Address - Zip Code:76549-4594
Mailing Address - Country:US
Mailing Address - Phone:254-265-6200
Mailing Address - Fax:
Practice Address - Street 1:1711 E CENTRAL TEXAS EXPY STE 304
Practice Address - Street 2:
Practice Address - City:KILLEEN
Practice Address - State:TX
Practice Address - Zip Code:76541-9147
Practice Address - Country:US
Practice Address - Phone:254-265-6200
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-06-25
Last Update Date:2019-06-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Multi-Specialty