Provider Demographics
NPI:1386064327
Name:AUTISM EDUCATION AND RESEARCH INSTITUTE
Entity type:Organization
Organization Name:AUTISM EDUCATION AND RESEARCH INSTITUTE
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:DIR OF CLINICAL & BUSINESS SYSTEMS
Authorized Official - Prefix:
Authorized Official - First Name:KAREN
Authorized Official - Middle Name:
Authorized Official - Last Name:FRIDG
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:724-850-1750
Mailing Address - Street 1:PO BOX 1786
Mailing Address - Street 2:
Mailing Address - City:GREENSBURG
Mailing Address - State:PA
Mailing Address - Zip Code:15601-6786
Mailing Address - Country:US
Mailing Address - Phone:724-850-1750
Mailing Address - Fax:866-501-2374
Practice Address - Street 1:200 RENAISSANCE DR
Practice Address - Street 2:STE 401, WARNER CENTER
Practice Address - City:BUTLER
Practice Address - State:PA
Practice Address - Zip Code:16001-7612
Practice Address - Country:US
Practice Address - Phone:724-850-1750
Practice Address - Fax:724-420-5318
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:AUTISM EDUCATION AND RESEARCH INSTITUTE
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2014-04-17
Last Update Date:2014-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA442830251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1023398360003Medicaid