Basic Information
| Provider Information | |||||||||
| NPI: | 1023453701 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | AUTISM BEHAVIOR CONSULTING GROUP, INC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 99-950 IWAENA ST FL 2 | ||||||||
| Address2: | |||||||||
| City: | AIEA | ||||||||
| State: | HI | ||||||||
| PostalCode: | 967015645 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8082777736 | ||||||||
| FaxNumber: | 8087480202 | ||||||||
| Practice Location | |||||||||
| Address1: | 99-950 IWAENA ST FL 2 | ||||||||
| Address2: | |||||||||
| City: | AIEA | ||||||||
| State: | HI | ||||||||
| PostalCode: | 967015645 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8082777736 | ||||||||
| FaxNumber: | 8087480202 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 05/07/2013 | ||||||||
| LastUpdateDate: | 05/07/2013 | ||||||||
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| AuthorizedOfficialLastName: | WIECH | ||||||||
| AuthorizedOfficialFirstName: | AMY | ||||||||
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| AuthorizedOfficialTitleorPosition: | CEO/FOUNDER | ||||||||
| AuthorizedOfficialTelephone: | 8082777736 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | MRS. | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 251S00000X | 0-12-5053 | HI | Y | Agencies | Community/Behavioral Health |
No ID Information.