Organization
GOT-AUTISM, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TAMARA LUCILLE ANDERSSON (PRESIDENT)
(513) 881-6363
Entity
Organization
Contact information
Practice address
10052 COMMERCE PARK DR, WEST CHESTER, OH 45246-1334
(513) 881-6363
(513) 881-7010
Mailing address
10052 COMMERCE PARK DR, WEST CHESTER, OH 45246-1334
(513) 881-6363
(513) 881-7010
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
M092803
MEDICAID WAIVER
OH
Enumeration date
06/08/2015
Last updated
06/08/2015
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