Provider Demographics
NPI:1538344874
Name:CHILDREN'S AUTISM TREATMENT SPECIALISTS, LLC.
Entity type:Organization
Organization Name:CHILDREN'S AUTISM TREATMENT SPECIALISTS, LLC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINICAL DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:LAURA
Authorized Official - Middle Name:P
Authorized Official - Last Name:O'SULLIVAN
Authorized Official - Suffix:
Authorized Official - Credentials:PHD, BCBA
Authorized Official - Phone:239-985-2287
Mailing Address - Street 1:18070 S TAMIAMI TRL
Mailing Address - Street 2:UNIT 16
Mailing Address - City:FORT MYERS
Mailing Address - State:FL
Mailing Address - Zip Code:33908-4602
Mailing Address - Country:US
Mailing Address - Phone:239-985-2287
Mailing Address - Fax:239-481-2287
Practice Address - Street 1:18070 S TAMIAMI TRL
Practice Address - Street 2:UNIT 16
Practice Address - City:FORT MYERS
Practice Address - State:FL
Practice Address - Zip Code:33908-4602
Practice Address - Country:US
Practice Address - Phone:239-985-2287
Practice Address - Fax:239-481-2287
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-01-06
Last Update Date:2008-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL1-07-3890252Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes252Y00000XAgenciesEarly Intervention Provider Agency