Provider Demographics
NPI:1952850968
Name:COMPREHENSIVE AUTISM CONSULTING LLC
Entity Type:Organization
Organization Name:COMPREHENSIVE AUTISM CONSULTING LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ASSISTANT DIRECTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:SARAH
Authorized Official - Middle Name:
Authorized Official - Last Name:GATES
Authorized Official - Suffix:
Authorized Official - Credentials:EDS
Authorized Official - Phone:508-813-6622
Mailing Address - Street 1:21 KENSINGTON CT
Mailing Address - Street 2:
Mailing Address - City:SWANSEA
Mailing Address - State:MA
Mailing Address - Zip Code:02777-3566
Mailing Address - Country:US
Mailing Address - Phone:508-813-6622
Mailing Address - Fax:
Practice Address - Street 1:21 KENSINGTON CT
Practice Address - Street 2:
Practice Address - City:SWANSEA
Practice Address - State:MA
Practice Address - Zip Code:02777-3566
Practice Address - Country:US
Practice Address - Phone:508-813-6622
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:COMPREHENSIVE AUTISM CONSULTING LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2016-10-03
Last Update Date:2016-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA0620251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health