Provider Demographics
NPI:1891864740
Name:AUTISTIC SERVICES, INC.
Entity Type:Organization
Organization Name:AUTISTIC SERVICES, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:VERONICA
Authorized Official - Middle Name:E
Authorized Official - Last Name:FEDERICONI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:716-631-5777
Mailing Address - Street 1:4444 BRYANT STRATTON WAY
Mailing Address - Street 2:
Mailing Address - City:WILLIAMSVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:14221
Mailing Address - Country:US
Mailing Address - Phone:716-631-5777
Mailing Address - Fax:716-631-2834
Practice Address - Street 1:80 ACACIA DR
Practice Address - Street 2:
Practice Address - City:AMHERST
Practice Address - State:NY
Practice Address - Zip Code:14228-1937
Practice Address - Country:US
Practice Address - Phone:716-631-5777
Practice Address - Fax:716-631-2834
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-07
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes320900000XResidential Treatment FacilitiesCommunity Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01251798Medicaid