Provider Demographics
NPI:1245963644
Name:AUTISM & BEHAVIOR THERAPY, CO.
Entity type:Organization
Organization Name:AUTISM & BEHAVIOR THERAPY, CO.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:FOUNDER & CEO
Authorized Official - Prefix:
Authorized Official - First Name:ANNMARIE
Authorized Official - Middle Name:
Authorized Official - Last Name:GRANJA
Authorized Official - Suffix:
Authorized Official - Credentials:BCBA
Authorized Official - Phone:951-302-8036
Mailing Address - Street 1:33002 ROMERO DR
Mailing Address - Street 2:
Mailing Address - City:TEMECULA
Mailing Address - State:CA
Mailing Address - Zip Code:92592-1117
Mailing Address - Country:US
Mailing Address - Phone:951-302-8036
Mailing Address - Fax:
Practice Address - Street 1:33002 ROMERO DR
Practice Address - Street 2:
Practice Address - City:TEMECULA
Practice Address - State:CA
Practice Address - Zip Code:92592-1117
Practice Address - Country:US
Practice Address - Phone:951-302-8036
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-07-05
Last Update Date:2024-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Single Specialty