Provider Demographics
NPI:1639451917
Name:ANDERSON CENTER FOR AUTISM
Entity type:Organization
Organization Name:ANDERSON CENTER FOR AUTISM
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:M.S. OTR
Authorized Official - Prefix:MRS
Authorized Official - First Name:KAREN
Authorized Official - Middle Name:MARIE
Authorized Official - Last Name:BROWN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:845-889-9436
Mailing Address - Street 1:3 LAFAYETTE PL BSMT
Mailing Address - Street 2:
Mailing Address - City:POUGHKEEPSIE
Mailing Address - State:NY
Mailing Address - Zip Code:12601-3016
Mailing Address - Country:US
Mailing Address - Phone:845-889-9436
Mailing Address - Fax:
Practice Address - Street 1:378 VIOLET AVE
Practice Address - Street 2:
Practice Address - City:POUGHKEEPSIE
Practice Address - State:NY
Practice Address - Zip Code:12601-1034
Practice Address - Country:US
Practice Address - Phone:845-485-1165
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-09-13
Last Update Date:2011-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251C00000XAgenciesDay Training, Developmentally Disabled Services