Provider Demographics
NPI:1689320814
Name:CENTER FOR AUTISM & RELATED DISORDERS, LLC
Entity Type:Organization
Organization Name:CENTER FOR AUTISM & RELATED DISORDERS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CONTRACTS
Authorized Official - Prefix:
Authorized Official - First Name:KELLY
Authorized Official - Middle Name:
Authorized Official - Last Name:FRANCIS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:818-345-2345
Mailing Address - Street 1:5850 GRANITE PKWY STE 600
Mailing Address - Street 2:
Mailing Address - City:PLANO
Mailing Address - State:TX
Mailing Address - Zip Code:75024-6753
Mailing Address - Country:US
Mailing Address - Phone:469-694-1754
Mailing Address - Fax:
Practice Address - Street 1:277 HIGHWAY 74 N STE 108
Practice Address - Street 2:
Practice Address - City:PEACHTREE CITY
Practice Address - State:GA
Practice Address - Zip Code:30269-1570
Practice Address - Country:US
Practice Address - Phone:818-345-2345
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-02-25
Last Update Date:2022-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Single Specialty