Provider Demographics
NPI:1548647431
Name:AUTISM BRIGHT FUTURES, INC.
Entity type:Organization
Organization Name:AUTISM BRIGHT FUTURES, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:LORENA
Authorized Official - Middle Name:
Authorized Official - Last Name:DECKER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:757-296-0442
Mailing Address - Street 1:237 HANBURY RD E
Mailing Address - Street 2:STE. 17-197
Mailing Address - City:CHESAPEAKE
Mailing Address - State:VA
Mailing Address - Zip Code:23322-6621
Mailing Address - Country:US
Mailing Address - Phone:757-296-0442
Mailing Address - Fax:252-565-0061
Practice Address - Street 1:237 HANBURY RD E
Practice Address - Street 2:STE. 17-197
Practice Address - City:CHESAPEAKE
Practice Address - State:VA
Practice Address - Zip Code:23322-6621
Practice Address - Country:US
Practice Address - Phone:757-296-0442
Practice Address - Fax:252-565-0061
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-04-30
Last Update Date:2015-04-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA1-15-18427103K00000X
NC1-15-18427103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Multi-Specialty