Provider Demographics
NPI:1770648396
Name:AUTISM EARLY INTERVENTION CLINICS
Entity Type:Organization
Organization Name:AUTISM EARLY INTERVENTION CLINICS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:FRANS
Authorized Official - Middle Name:
Authorized Official - Last Name:VAN HAAREN
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:727-576-7600
Mailing Address - Street 1:8950 DR ML KING STREET N
Mailing Address - Street 2:SUITE 170
Mailing Address - City:ST PETERSBURG
Mailing Address - State:FL
Mailing Address - Zip Code:33702
Mailing Address - Country:US
Mailing Address - Phone:727-576-7600
Mailing Address - Fax:727-388-6879
Practice Address - Street 1:8950 DR ML KING STREET N
Practice Address - Street 2:SUITE 170
Practice Address - City:ST PETERSBURG
Practice Address - State:FL
Practice Address - Zip Code:33702
Practice Address - Country:US
Practice Address - Phone:727-576-7600
Practice Address - Fax:727-388-6879
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-26
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health