| Autism Spectrum Disorder Outpatient Program | |
|
1221 W Lakeview Ave Pensacola FL 32501-1836 | |
| (850) 469-3500 | |
| Not Available |
| Full Name | Autism Spectrum Disorder Outpatient Program |
|---|---|
| Speciality | Behavior Analyst |
| Location | 1221 W Lakeview Ave, Pensacola, Florida |
| Authorized Official Name and Position | M. Allison Hill (CEO) |
| Authorized Official Contact | 8504693500 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Autism Spectrum Disorder Outpatient Program 1221 W Lakeview Ave Pensacola FL 32501-1836 Ph: (850) 469-3500 | Autism Spectrum Disorder Outpatient Program 1221 W Lakeview Ave Pensacola FL 32501-1836 Ph: (850) 469-3500 |
| NPI Number | 1588337646 |
|---|---|
| Provider Enumeration Date | 07/26/2021 |
| Last Update Date | 08/27/2021 |
| Certification Date | 08/19/2021 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1588337646 | NPI | - | NPPES |
| 017506700 | Medicaid | FL |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103K00000X | Behavior Analyst | (* (Not Available)) | Primary |
| 261QM0855X | Clinic/center - Adolescent And Children Mental Health | (* (Not Available)) | Secondary |
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