Provider Demographics
NPI:1760054712
Name:SACRAMENTO AUTISTIC SPECTRUM AND SPECIAL NEEDS ALLIANCE, INC.
Entity Type:Organization
Organization Name:SACRAMENTO AUTISTIC SPECTRUM AND SPECIAL NEEDS ALLIANCE, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:
Authorized Official - Last Name:GAINES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:916-416-3113
Mailing Address - Street 1:PO BOX 254788
Mailing Address - Street 2:
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95865-4788
Mailing Address - Country:US
Mailing Address - Phone:916-877-5220
Mailing Address - Fax:
Practice Address - Street 1:2030 W EL CAMINO AVE STE 260
Practice Address - Street 2:
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95833-1868
Practice Address - Country:US
Practice Address - Phone:916-877-5220
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-07-10
Last Update Date:2021-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225C00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRehabilitation CounselorGroup - Multi-Specialty
No171M00000XOther Service ProvidersCase Manager/Care CoordinatorGroup - Multi-Specialty