Provider Demographics
NPI:1245925817
Name:AGING WITH AUTISM
Entity type:Organization
Organization Name:AGING WITH AUTISM
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:FOUNDER/DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:CYNTHIA
Authorized Official - Middle Name:K
Authorized Official - Last Name:HAYES
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:908-904-9319
Mailing Address - Street 1:1201 TANNER AVE
Mailing Address - Street 2:
Mailing Address - City:BURLINGTON
Mailing Address - State:NJ
Mailing Address - Zip Code:08016-2343
Mailing Address - Country:US
Mailing Address - Phone:908-904-9319
Mailing Address - Fax:
Practice Address - Street 1:1201 TANNER AVE
Practice Address - Street 2:
Practice Address - City:BURLINGTON
Practice Address - State:NJ
Practice Address - Zip Code:08016-2343
Practice Address - Country:US
Practice Address - Phone:908-904-9319
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:AGING WITH AUTISM
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2023-04-10
Last Update Date:2023-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health