Provider Demographics
NPI:1063874147
Name:QUALITY SERVICES FOR THE AUTISM COMMUNITY
Entity type:Organization
Organization Name:QUALITY SERVICES FOR THE AUTISM COMMUNITY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF AFTER SCHOOL PROGRAMS
Authorized Official - Prefix:
Authorized Official - First Name:DITA
Authorized Official - Middle Name:
Authorized Official - Last Name:DESENA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:718-728-8476
Mailing Address - Street 1:253 W 35TH ST
Mailing Address - Street 2:14TH FLOOR
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10001-1907
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:253 W 35TH ST
Practice Address - Street 2:14TH FLOOR
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10001-1907
Practice Address - Country:US
Practice Address - Phone:718-728-8476
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-03-28
Last Update Date:2016-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY001098-1251V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251V00000XAgenciesVoluntary or Charitable