Evolution Autism
Early Intervention Provider Agency in Grand Prairie, TX. Organization (NPI-2).
NPI number1710698378
StatusActive
Last updated in NPPESDec 5, 2022
Details
- NPI
- 1710698378
- Entity type
- Organization (NPI-2)
- Legal business name
- Evolution Autism
- Organization subpart
- No
- Enumeration date
- Dec 5, 2022
- Certification date
- Dec 5, 2022
- Last updated
- Dec 5, 2022
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 252Y00000X | Early Intervention Provider Agency | – | – | Yes |
| 251V00000X | Voluntary or Charitable | – | – | |
| 253Z00000X | In Home Supportive Care | – | – | |
| 261Q00000X | Clinic/Center | – | – | |
| 251S00000X | Community/Behavioral Health | – | – | |
| 261QD1600X | Clinic/Center, Developmental Disabilities | – | – | |
| 261QM0801X | Clinic/Center, Mental Health (Including Community Mental Health Center) | – | – | |
| 320600000X | Residential Treatment Facility, Intellectual and/or Developmental Disabilities | – | – | |
| 385HR2060X | Respite Care, Respite Care, Intellectual and/or Developmental Disabilities, Child | – | – | |
| 385HR2065X | Respite Care, Respite Care, Physical Disabilities, Child | – | – |
Practice location
1801 S Great Southwest PkwyGrand Prairie, TX 75051-3542
Phone 214-984-4189
Mailing address
822 Weaver StCedar Hill, TX 75104-9235
Authorized official
Gabrielle Roseman
Director
2149844189
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