Provider Demographics
NPI:1932415056
Name:CENTER FOR AUTISM SPECTRUM TREATMENT, INC
Entity Type:Organization
Organization Name:CENTER FOR AUTISM SPECTRUM TREATMENT, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINICAL DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:EFTHYMIA
Authorized Official - Middle Name:MARIA
Authorized Official - Last Name:PYLADAKI
Authorized Official - Suffix:
Authorized Official - Credentials:MS, BCBA
Authorized Official - Phone:310-985-0372
Mailing Address - Street 1:311 N ROBERTSON BLVD STE 421
Mailing Address - Street 2:
Mailing Address - City:BEVERLY HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:90211-1705
Mailing Address - Country:US
Mailing Address - Phone:310-985-0372
Mailing Address - Fax:310-943-6813
Practice Address - Street 1:11940 SAN VICENTE BLVD STE 255
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90049-5004
Practice Address - Country:US
Practice Address - Phone:310-985-0372
Practice Address - Fax:310-943-6813
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-08-26
Last Update Date:2010-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CABACB1095670251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health