Provider Demographics
NPI:1730473117
Name:CHILDHOOD AUTISM SERVICES, INC
Entity Type:Organization
Organization Name:CHILDHOOD AUTISM SERVICES, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:THERESA
Authorized Official - Middle Name:
Authorized Official - Last Name:NEWTON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:402-680-3088
Mailing Address - Street 1:2005 DANA LN
Mailing Address - Street 2:
Mailing Address - City:PAPILLION
Mailing Address - State:NE
Mailing Address - Zip Code:68133-2339
Mailing Address - Country:US
Mailing Address - Phone:402-680-3088
Mailing Address - Fax:402-881-8383
Practice Address - Street 1:2005 DANA LN
Practice Address - Street 2:
Practice Address - City:PAPILLION
Practice Address - State:NE
Practice Address - Zip Code:68133-2339
Practice Address - Country:US
Practice Address - Phone:402-680-3088
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-06-03
Last Update Date:2011-07-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health