Provider Demographics
NPI:1295070464
Name:AUTISM SERVICES NORTH
Entity type:Organization
Organization Name:AUTISM SERVICES NORTH
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRACTICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:LISA
Authorized Official - Middle Name:
Authorized Official - Last Name:GIBBNER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:800-306-8602
Mailing Address - Street 1:39 TANNERY RD
Mailing Address - Street 2:
Mailing Address - City:DILLSBURG
Mailing Address - State:PA
Mailing Address - Zip Code:17019-9673
Mailing Address - Country:US
Mailing Address - Phone:800-306-8650
Mailing Address - Fax:866-206-8602
Practice Address - Street 1:39 TANNERY RD
Practice Address - Street 2:
Practice Address - City:DILLSBURG
Practice Address - State:PA
Practice Address - Zip Code:17019-9673
Practice Address - Country:US
Practice Address - Phone:800-306-8650
Practice Address - Fax:866-206-8602
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-11-29
Last Update Date:2012-11-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes252Y00000XAgenciesEarly Intervention Provider Agency