Provider Demographics
NPI:1841639978
Name:AUTISM PEDIATRIC THERAPY & LEARNING CENTER LLC
Entity type:Organization
Organization Name:AUTISM PEDIATRIC THERAPY & LEARNING CENTER LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:MR
Authorized Official - First Name:IAN
Authorized Official - Middle Name:N
Authorized Official - Last Name:MACINNES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:713-355-0623
Mailing Address - Street 1:PO BOX 281
Mailing Address - Street 2:
Mailing Address - City:PEARLAND
Mailing Address - State:TX
Mailing Address - Zip Code:77588-0281
Mailing Address - Country:US
Mailing Address - Phone:713-355-0623
Mailing Address - Fax:888-971-3923
Practice Address - Street 1:7904 BROADWAY ST
Practice Address - Street 2:
Practice Address - City:PEARLAND
Practice Address - State:TX
Practice Address - Zip Code:77581-7758
Practice Address - Country:US
Practice Address - Phone:713-355-0623
Practice Address - Fax:888-971-3923
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-06-21
Last Update Date:2013-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL1-01-0649251C00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251C00000XAgenciesDay Training, Developmentally Disabled Services