NPIMap

Organization Active NPI

Autism Treatment Center Rehabilitation Agency

  • Rehabilitation Clinic/Center
  • Dallas, TX
National Provider Identifier
1073063871
Registry record updated Oct 5, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rehabilitation Clinic/CenterTaxonomy code 261QR0400X
License
108938 Issued in TX
Legal business name
AUTISM TREATMENT CENTER REHABILITATION AGENCY
Practice address
10610 Metric Dr
#101
Dallas, TX 75243-5581
Phone
(214) 221-4405
NPI assigned
Oct 5, 2016
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 5, 2016

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Loretta Outlaw-Lam
Title
Administrator
Phone
(469) 341-0103

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Rehabilitation Clinic/Center 261QR0400X 108938 TX Primary
Rehabilitation Hospital 283X00000X

Addresses

Primary practice location

10610 Metric Dr
#101
Dallas, TX 75243-5581

Mailing address

10610 Metric Dr
#101
Dallas, TX 75243-5581

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

Outpatient physical therapy / speech pathology certification: CCN 676663

Name & address match This certification has no NPI in the Medicare enrollment files. CMS publishes enrollment files for six facility types only, so it was connected to this NPI by matching the name and address CMS publishes for it.

Legal name
AUTISM TREATMENT CENTER REHABILITATION AGENCY
Certification status
Active
Provider type (POS)
Outpatient physical therapy / speech pathology
Participating since
Apr 14, 2009
Last certification
Oct 26, 2015
Ownership / control type
VOLUNTARY NON PROFIT OTHER THAN CHURCH
Facility address
10610 Metric Drive
Dallas, TX 75243

National Provider Directory

National Provider Directory
Tax ID family
Autism Treatment Center Rehabilitation Agency11 organizations share this tax ID, including this one

Other organizations with this tax ID 10

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1475625600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1475625600000",
    "number": "1073063871",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10610 METRIC DR",
            "address_2": "#101",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752435581"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10610 METRIC DR",
            "address_2": "#101",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752435581",
            "telephone_number": "214-221-4405"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AUTISM TREATMENT CENTER REHABILITATION AGENCY",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-10-05",
        "last_updated": "2016-10-05",
        "status": "A",
        "authorized_official_last_name": "OUTLAW-LAM",
        "authorized_official_first_name": "LORETTA",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "469-341-0103"
    },
    "taxonomies": [
        {
            "code": "261QR0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation",
            "state": "TX",
            "license": "108938",
            "primary": true
        },
        {
            "code": "283X00000X",
            "taxonomy_group": "",
            "desc": "Rehabilitation Hospital",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dallas, TX

Sources for this page

Verify at the official NPI Registry.