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PETALU'DA AUTISM SERVICES LLC

Professional

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Contact Information

PETALU'DA AUTISM SERVICES LLC
6 ELIZABETH LN
VERNON, CT  06066-5056
 Phone: 860-983-8112
 Fax:
 Website:
 

Specialty

 Taxonomy Code Specialty Code Provider Type

Professional

 101YP2500X
 

Point of Service

 305S00000X
Indicates primary specialty

NPI Profile & details for PETALU'DA AUTISM SERVICES LLC

NPI Number 1245578475
LBN Legal business name PETALU'DA AUTISM SERVICES LLC
Authorized official KEISHA POWELL - (AUTISM THERAPIST)
Entity Organization
Organization subpart 1 No
Enumeration date 01/23/2013
Last updated 11/08/2014 - About 12 years ago
Identifiers
CT License # 11211741
CT License # 3928518916
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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