Provider Demographics
NPI:1194959767
Name:LITTLE FRIENDS CENTER FOR AUTISM, INC.
Entity type:Organization
Organization Name:LITTLE FRIENDS CENTER FOR AUTISM, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE VICE PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:PATTI
Authorized Official - Middle Name:
Authorized Official - Last Name:BOHEME
Authorized Official - Suffix:
Authorized Official - Credentials:MS, LCPC
Authorized Official - Phone:630-305-6039
Mailing Address - Street 1:1001 E CHICAGO AVE
Mailing Address - Street 2:SUITE 151
Mailing Address - City:NAPERVILLE
Mailing Address - State:IL
Mailing Address - Zip Code:60540-5526
Mailing Address - Country:US
Mailing Address - Phone:630-305-6039
Mailing Address - Fax:630-355-3176
Practice Address - Street 1:1001 E CHICAGO AVE
Practice Address - Street 2:SUITE 151
Practice Address - City:NAPERVILLE
Practice Address - State:IL
Practice Address - Zip Code:60540-5526
Practice Address - Country:US
Practice Address - Phone:630-305-6039
Practice Address - Fax:630-355-3176
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:LITTLE FRIENDS, INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2009-05-11
Last Update Date:2009-05-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health