Provider Demographics
NPI:1255704573
Name:AUTISM AND BEHAVIOR SOLUTIONS, LLC
Entity type:Organization
Organization Name:AUTISM AND BEHAVIOR SOLUTIONS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:JUDE
Authorized Official - Middle Name:N/A
Authorized Official - Last Name:JENKINS-SCHRACK
Authorized Official - Suffix:
Authorized Official - Credentials:BCBA
Authorized Official - Phone:702-279-8679
Mailing Address - Street 1:1076 BADGER RD
Mailing Address - Street 2:
Mailing Address - City:NORTH POLE
Mailing Address - State:AK
Mailing Address - Zip Code:99705-5047
Mailing Address - Country:US
Mailing Address - Phone:702-279-8679
Mailing Address - Fax:907-385-0633
Practice Address - Street 1:1076 BADGER RD
Practice Address - Street 2:
Practice Address - City:NORTH POLE
Practice Address - State:AK
Practice Address - Zip Code:99705-5047
Practice Address - Country:US
Practice Address - Phone:702-279-8679
Practice Address - Fax:907-385-0633
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-11-09
Last Update Date:2015-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AKBEVB10251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health