Provider Demographics
NPI:1598587990
Name:MARTINS CENTER FOR AUTISM
Entity type:Organization
Organization Name:MARTINS CENTER FOR AUTISM
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:FELIPE
Authorized Official - Middle Name:
Authorized Official - Last Name:LIMA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:801-205-6638
Mailing Address - Street 1:1453 W DUCK POND LN
Mailing Address - Street 2:
Mailing Address - City:TAYLORSVILLE
Mailing Address - State:UT
Mailing Address - Zip Code:84123-5222
Mailing Address - Country:US
Mailing Address - Phone:801-205-6638
Mailing Address - Fax:
Practice Address - Street 1:1453 W DUCK POND LN
Practice Address - Street 2:
Practice Address - City:TAYLORSVILLE
Practice Address - State:UT
Practice Address - Zip Code:84123-5222
Practice Address - Country:US
Practice Address - Phone:801-205-6638
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-10-28
Last Update Date:2024-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Single Specialty