Northshore Autism Center, LLC
Organization Active NPI Early Intervention Provider Agency · Mandeville, LA
NPI 1629512652 · NPPES record last updated Jun 3, 2020
Key facts
- NPI
- 1629512652
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Early Intervention Provider Agency 252Y00000X
- Legal business name
- NORTHSHORE AUTISM CENTER, LLC
- Practice address
- 800 Jackson Ave
Mandeville, LA 70448-5328 - Phone
- (985) 502-1884
- Fax
- (504) 617-7811
- NPI assigned
- Dec 9, 2016
- Organization subpart
- No
Authorized official
- Name
- Chad Favre, M.S., BCBA, LBA
- Title
- Director
- Phone
- (985) 502-1884
Practitioners 5
-
Chad Favre, M.S., BCBA
-
Elizabeth Caroline Branch, MA,BCBA
-
Tara Freeman, BCBA
-
Savannah Joseph, M.ED, BCBA, LBA
-
Zoe Gabrielle Stpierre, M.A., BCBA, LBA
National Provider Directory
Locations
800 Jackson Ave
Mandeville, LA 70448
Phone (985) 231-7612
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Early Intervention Provider Agency | 252Y00000X | Yes |
Addresses
Primary practice location
800 Jackson Ave
Mandeville, LA 70448-5328
Mailing address
345 Forest Brook Blvd
Mandeville, LA 70448-8474
Phone (985) 502-1884
Other providers in Mandeville, LA
- Northlake Foot and Ankle Inc.
- Northlake Medical Psychology and Counseling
- Northlake Physical Therapy and Rehabilitation Services, Inc.
- Northlake Physicians Group
- Northshore Allergy & Immunology, LLC
- Northshore Behavior Innovations, LLC
- Northshore Gastroenterology, LLC
- Northshore Interpretive Medicine
- Northshore Laser & Vein Center LLC
- Northshore Orthodontics, LLC
All providers in Mandeville, LA · Early Intervention Provider Agency in Louisiana
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 3, 2020. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.