Provider Demographics
NPI:1023259595
Name:SPECTRUM CENTER FOR AUTISM AND RELATED DISORDERS, INC
Entity type:Organization
Organization Name:SPECTRUM CENTER FOR AUTISM AND RELATED DISORDERS, INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:CLAUDE
Authorized Official - Middle Name:THOMAS
Authorized Official - Last Name:ASHLEY
Authorized Official - Suffix:JR
Authorized Official - Credentials:MD, PHD
Authorized Official - Phone:334-671-1650
Mailing Address - Street 1:1501 HONEYSUCKLE RD
Mailing Address - Street 2:SUITE 2
Mailing Address - City:DOTHAN
Mailing Address - State:AL
Mailing Address - Zip Code:36305-1968
Mailing Address - Country:US
Mailing Address - Phone:334-671-1650
Mailing Address - Fax:334-671-1659
Practice Address - Street 1:1501 HONEYSUCKLE RD
Practice Address - Street 2:SUITE 2
Practice Address - City:DOTHAN
Practice Address - State:AL
Practice Address - Zip Code:36305-1968
Practice Address - Country:US
Practice Address - Phone:334-671-1650
Practice Address - Fax:334-671-1659
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-03-13
Last Update Date:2009-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Multi-Specialty
No225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatricsGroup - Multi-Specialty