Provider Demographics
NPI:1578803623
Name:AUTISM CARE WEST LLC
Entity type:Organization
Organization Name:AUTISM CARE WEST LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRACTICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:YELENA
Authorized Official - Middle Name:
Authorized Official - Last Name:MARRIOTT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:702-326-5996
Mailing Address - Street 1:2075 E WINDMILL LN STE 150
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89123-2085
Mailing Address - Country:US
Mailing Address - Phone:702-326-5996
Mailing Address - Fax:702-912-4662
Practice Address - Street 1:2075 E WINDMILL LN STE 150
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89123-2085
Practice Address - Country:US
Practice Address - Phone:702-326-5996
Practice Address - Fax:702-912-4662
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-02-27
Last Update Date:2025-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NVLBAT021913103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Single Specialty