Provider Demographics
NPI:1871053231
Name:AUTISM THERAPY CENTERS LLC
Entity type:Organization
Organization Name:AUTISM THERAPY CENTERS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR/PROVIDER
Authorized Official - Prefix:
Authorized Official - First Name:DANIECE
Authorized Official - Middle Name:
Authorized Official - Last Name:KERN
Authorized Official - Suffix:
Authorized Official - Credentials:BCBA
Authorized Official - Phone:702-423-2625
Mailing Address - Street 1:2055 W CHARLESTON BLVD STE C
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89102-2258
Mailing Address - Country:US
Mailing Address - Phone:702-423-2625
Mailing Address - Fax:
Practice Address - Street 1:2055 W CHARLESTON BLVD STE C
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89102-2258
Practice Address - Country:US
Practice Address - Phone:702-423-2625
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-03-21
Last Update Date:2022-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Single Specialty
No251S00000XAgenciesCommunity/Behavioral HealthGroup - Single Specialty