Provider Demographics
NPI:1982331955
Name:AUTISM CARE GROUP LLC
Entity Type:Organization
Organization Name:AUTISM CARE GROUP LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMIN
Authorized Official - Prefix:
Authorized Official - First Name:FAISAL
Authorized Official - Middle Name:
Authorized Official - Last Name:TARAKHAIL
Authorized Official - Suffix:
Authorized Official - Credentials:ADMIN
Authorized Official - Phone:571-488-8107
Mailing Address - Street 1:13160 PIEDMONT VISTA DR
Mailing Address - Street 2:
Mailing Address - City:HAYMARKET
Mailing Address - State:VA
Mailing Address - Zip Code:20169-2642
Mailing Address - Country:US
Mailing Address - Phone:571-488-8107
Mailing Address - Fax:571-408-4966
Practice Address - Street 1:13160 PIEDMONT VISTA DR
Practice Address - Street 2:
Practice Address - City:HAYMARKET
Practice Address - State:VA
Practice Address - Zip Code:20169-2642
Practice Address - Country:US
Practice Address - Phone:571-488-8107
Practice Address - Fax:571-408-4966
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-08-01
Last Update Date:2022-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Multi-Specialty