Provider Demographics
NPI:1962219139
Name:FOOTHILLS AUTISM SERVICES ABA LLC
Entity type:Organization
Organization Name:FOOTHILLS AUTISM SERVICES ABA LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:KATELYN
Authorized Official - Middle Name:
Authorized Official - Last Name:O'HEARN
Authorized Official - Suffix:
Authorized Official - Credentials:BCBA, LBA
Authorized Official - Phone:828-999-0355
Mailing Address - Street 1:209 EASTWOOD PARK CIR SE
Mailing Address - Street 2:
Mailing Address - City:LENOIR
Mailing Address - State:NC
Mailing Address - Zip Code:28645-6212
Mailing Address - Country:US
Mailing Address - Phone:828-999-0355
Mailing Address - Fax:
Practice Address - Street 1:209 EASTWOOD PARK CIR SE
Practice Address - Street 2:
Practice Address - City:LENOIR
Practice Address - State:NC
Practice Address - Zip Code:28645-6212
Practice Address - Country:US
Practice Address - Phone:828-999-0355
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-12-11
Last Update Date:2024-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Single Specialty