| Coastal Kids Autism Treatment Center, Llc | |
|
115 Tiffany St Rusk TX 75785-1601 | |
| (903) 805-9363 | |
| Not Available |
| Full Name | Coastal Kids Autism Treatment Center, Llc |
|---|---|
| Speciality | Behavior Analyst |
| Location | 115 Tiffany St, Rusk, Texas |
| Authorized Official Name and Position | Monette Woods (PARTNER/MANAGER) |
| Authorized Official Contact | 9038059363 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Coastal Kids Autism Treatment Center, Llc 115 Tiffany St Rusk TX 75785-1601 Ph: (903) 805-9363 | Coastal Kids Autism Treatment Center, Llc 115 Tiffany St Rusk TX 75785-1601 Ph: (903) 805-9363 |
| NPI Number | 1164195558 |
|---|---|
| Provider Enumeration Date | 07/30/2021 |
| Last Update Date | 07/30/2021 |
| Certification Date | 07/30/2021 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1164195558 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103K00000X | Behavior Analyst | (* (Not Available)) | Primary |
Rusk State Hospital Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 805 North Dickinson, Rusk, TX 75785 Phone: 903-683-7201 Fax: 903-683-7199 |