| Autism Services Center | |
|
10 6th Ave W Huntington WV 25701-0028 | |
| (304) 525-8014 | |
| (304) 525-8026 |
| Full Name | Autism Services Center |
|---|---|
| Speciality | Clinic/center - Adolescent And Children Mental Health |
| Location | 10 6th Ave W, Huntington, West Virginia |
| Authorized Official Name and Position | Mike J Grady (CHIEF OPERATIONS OFFICER) |
| Authorized Official Contact | 3055258014 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Autism Services Center 10 6th Ave W Huntington WV 25701-0028 Ph: (304) 525-8014 | Autism Services Center 10 6th Ave W Huntington WV 25701-0028 Ph: (304) 525-8014 |
| NPI Number | 1912034232 |
|---|---|
| Provider Enumeration Date | 02/27/2007 |
| Last Update Date | 12/09/2020 |
| Certification Date | 12/09/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1912034232 | NPI | - | NPPES |
| 0023400001 | Medicaid | WV |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0855X | Clinic/center - Adolescent And Children Mental Health | 35 (West Virginia) | Primary |
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