Provider Demographics
NPI:1851073860
Name:ANDERSON-KHIMANI CENTER FOR EARLY INTERVENTION AND AUTISM SERVICES
Entity Type:Organization
Organization Name:ANDERSON-KHIMANI CENTER FOR EARLY INTERVENTION AND AUTISM SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING EMPLOYEE
Authorized Official - Prefix:
Authorized Official - First Name:LIZNA
Authorized Official - Middle Name:
Authorized Official - Last Name:KHIMANI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:804-728-8827
Mailing Address - Street 1:14497 POTOMAC MILLS RD # 1064
Mailing Address - Street 2:
Mailing Address - City:WOODBRIDGE
Mailing Address - State:VA
Mailing Address - Zip Code:22192-6807
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:14497 POTOMAC MILLS RD # 1064
Practice Address - Street 2:
Practice Address - City:WOODBRIDGE
Practice Address - State:VA
Practice Address - Zip Code:22192-6807
Practice Address - Country:US
Practice Address - Phone:804-728-8827
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-08-01
Last Update Date:2023-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center