Provider Demographics
NPI:1942786363
Name:PARENTS DEFEATING AUTISM TODAY
Entity Type:Organization
Organization Name:PARENTS DEFEATING AUTISM TODAY
Other - Org Name:CENTER FOR ASD
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:LISA
Authorized Official - Middle Name:M
Authorized Official - Last Name:BOULTINGHOUSE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:817-205-1445
Mailing Address - Street 1:PO BOX 516
Mailing Address - Street 2:
Mailing Address - City:CROWLEY
Mailing Address - State:TX
Mailing Address - Zip Code:76036-0516
Mailing Address - Country:US
Mailing Address - Phone:817-205-1445
Mailing Address - Fax:
Practice Address - Street 1:400 S EAGLE DR
Practice Address - Street 2:
Practice Address - City:CROWLEY
Practice Address - State:TX
Practice Address - Zip Code:76036-3321
Practice Address - Country:US
Practice Address - Phone:817-205-1445
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-07-18
Last Update Date:2018-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes385H00000XRespite Care FacilityRespite Care