Provider Demographics
NPI:1881902815
Name:AUTISM SOLUTIONS
Entity type:Organization
Organization Name:AUTISM SOLUTIONS
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER/MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:STEPHANIE
Authorized Official - Middle Name:D
Authorized Official - Last Name:FROST
Authorized Official - Suffix:
Authorized Official - Credentials:SLP
Authorized Official - Phone:207-458-9916
Mailing Address - Street 1:23 BEECHWOOD DR
Mailing Address - Street 2:
Mailing Address - City:WINTHROP
Mailing Address - State:ME
Mailing Address - Zip Code:04364-3314
Mailing Address - Country:US
Mailing Address - Phone:207-458-9916
Mailing Address - Fax:866-416-3820
Practice Address - Street 1:23 BEECHWOOD DR
Practice Address - Street 2:
Practice Address - City:WINTHROP
Practice Address - State:ME
Practice Address - Zip Code:04364-3314
Practice Address - Country:US
Practice Address - Phone:207-458-9916
Practice Address - Fax:866-416-3820
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-09-24
Last Update Date:2010-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MESP777252Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes252Y00000XAgenciesEarly Intervention Provider Agency
Provider Identifiers
StateIdentifier IDID TypeIssuer
ME201980000Medicaid