Provider Demographics
NPI:1760169585
Name:AUTISM AND BEHAVIORAL THERAPEUTICS
Entity Type:Organization
Organization Name:AUTISM AND BEHAVIORAL THERAPEUTICS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:ABHAY
Authorized Official - Middle Name:
Authorized Official - Last Name:GUPTA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:507-351-3736
Mailing Address - Street 1:115 ROSE GARDEN WAY
Mailing Address - Street 2:
Mailing Address - City:RED OAK
Mailing Address - State:TX
Mailing Address - Zip Code:75154-8864
Mailing Address - Country:US
Mailing Address - Phone:507-351-3736
Mailing Address - Fax:
Practice Address - Street 1:115 ROSE GARDEN WAY
Practice Address - Street 2:
Practice Address - City:RED OAK
Practice Address - State:TX
Practice Address - Zip Code:75154-8864
Practice Address - Country:US
Practice Address - Phone:507-351-3736
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-07-03
Last Update Date:2023-07-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes252Y00000XAgenciesEarly Intervention Provider Agency