Provider Demographics
NPI:1821552878
Name:ATLANTIC AUTISM SERVICES, INC.
Entity Type:Organization
Organization Name:ATLANTIC AUTISM SERVICES, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATIVE ASSISTANT
Authorized Official - Prefix:
Authorized Official - First Name:AFTON
Authorized Official - Middle Name:
Authorized Official - Last Name:MARKUN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:252-677-7060
Mailing Address - Street 1:1431B WEEKSVILLE RD
Mailing Address - Street 2:
Mailing Address - City:ELIZABETH CITY
Mailing Address - State:NC
Mailing Address - Zip Code:27909-8431
Mailing Address - Country:US
Mailing Address - Phone:252-677-5100
Mailing Address - Fax:252-677-5110
Practice Address - Street 1:1431B WEEKSVILLE RD
Practice Address - Street 2:
Practice Address - City:ELIZABETH CITY
Practice Address - State:NC
Practice Address - Zip Code:27909-8431
Practice Address - Country:US
Practice Address - Phone:252-677-5100
Practice Address - Fax:252-677-5110
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-01-24
Last Update Date:2020-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Single Specialty