Provider Demographics
NPI:1952716615
Name:AUTISM BEHAVIORAL CHANGES LLC
Entity Type:Organization
Organization Name:AUTISM BEHAVIORAL CHANGES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:DIAH
Authorized Official - Middle Name:
Authorized Official - Last Name:ASKARI
Authorized Official - Suffix:
Authorized Official - Credentials:MS,BCBA
Authorized Official - Phone:412-519-9915
Mailing Address - Street 1:2445 SW 18TH TER
Mailing Address - Street 2:APT 123
Mailing Address - City:FORT LAUDERDALE
Mailing Address - State:FL
Mailing Address - Zip Code:33315-2200
Mailing Address - Country:US
Mailing Address - Phone:412-519-9915
Mailing Address - Fax:
Practice Address - Street 1:2445 SW 18TH TER
Practice Address - Street 2:APT 123
Practice Address - City:FORT LAUDERDALE
Practice Address - State:FL
Practice Address - Zip Code:33315-2200
Practice Address - Country:US
Practice Address - Phone:412-519-9915
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-06-20
Last Update Date:2014-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL1-13-14069103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Single Specialty