Basic Information
Provider Information | |||||||||
NPI: | 1598020307 | ||||||||
EntityType: | 2 | ||||||||
ReplacementNPI: |   | ||||||||
OrganizationName: | AUTISM TREATMENT SOLUTIONS, LLC | ||||||||
LastName: |   | ||||||||
FirstName: |   | ||||||||
MiddleName: |   | ||||||||
NamePrefix: |   | ||||||||
NameSuffix: |   | ||||||||
Credential: |   | ||||||||
OtherOrganizationName: |   | ||||||||
OtherOrganizationType: |   | ||||||||
OtherLastName: |   | ||||||||
OtherFirstName: |   | ||||||||
OtherMiddleName: |   | ||||||||
OtherNamePrefix: |   | ||||||||
OtherNameSuffix: |   | ||||||||
OtherCredential: |   | ||||||||
OtherLastNameType: |   | ||||||||
Mailing Information | |||||||||
Address1: | 350 FAIRWAY DR STE 101 | ||||||||
Address2: |   | ||||||||
City: | DEERFIELD BEACH | ||||||||
State: | FL | ||||||||
PostalCode: | 334411834 | ||||||||
CountryCode: | US | ||||||||
TelephoneNumber: | 9546037885 | ||||||||
FaxNumber: | 8665002186 | ||||||||
Practice Location | |||||||||
Address1: | 350 FAIRWAY DR STE 101 | ||||||||
Address2: |   | ||||||||
City: | DEERFIELD BEACH | ||||||||
State: | FL | ||||||||
PostalCode: | 334411834 | ||||||||
CountryCode: | US | ||||||||
TelephoneNumber: | 8888809270 | ||||||||
FaxNumber: | 9543420273 | ||||||||
Other Information | |||||||||
ProviderEnumerationDate: | 07/09/2012 | ||||||||
LastUpdateDate: | 01/31/2022 | ||||||||
NPIDeactivationReasonCode: |   | ||||||||
NPIDeactivationDate: |   | ||||||||
NPIReactivationDate: |   | ||||||||
ProviderGenderCode: |   | ||||||||
AuthorizedOfficialLastName: | SILVER | ||||||||
AuthorizedOfficialFirstName: | KEVIN | ||||||||
AuthorizedOfficialMiddleName: |   | ||||||||
AuthorizedOfficialTitleorPosition: | CHIEF FINANCIAL OFFICER | ||||||||
AuthorizedOfficialTelephone: | 9546037885 | ||||||||
IsSoleProprietor: |   | ||||||||
IsOrganizationSubpart: | N | ||||||||
ParentOrganizationLBN: |   | ||||||||
AuthorizedOfficialNamePrefix: |   | ||||||||
AuthorizedOfficialNameSuffix: |   | ||||||||
AuthorizedOfficialCredential: |   | ||||||||
NPICertificationDate: | 01/31/2022 |
Taxonomy Information
Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 103K00000X |   |   | N | 193200000X MULTI-SPECIALTY GROUP | Behavioral Health & Social Service Providers | Behavioral Analyst |   | 1041C0700X |   |   | N | 193200000X MULTI-SPECIALTY GROUP | Behavioral Health & Social Service Providers | Social Worker | Clinical | 106E00000X |   |   | N | 193200000X MULTI-SPECIALTY GROUP |   |   |   | 106H00000X |   |   | N | 193200000X MULTI-SPECIALTY GROUP | Behavioral Health & Social Service Providers | Marriage & Family Therapist |   | 222Q00000X |   |   | N | 193200000X MULTI-SPECIALTY GROUP | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Developmental Therapist |   | 252Y00000X |   |   | N |   | Agencies | Early Intervention Provider Agency |   | 251S00000X |   |   | Y |   | Agencies | Community/Behavioral Health |   |
No ID Information.