Organization
BLUE AUTISM SERVICES LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. VIVEK R SAMA (OWNER FOUNDER)
(609) 439-1032
Entity
Organization
Contact information
Practice address
836 PECAN TREE LN, FORT MILL, SC 29715-7010
(609) 439-1032
Mailing address
836 PECAN TREE LN, FORT MILL, SC 29715-7010
(609) 439-1032
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
—
—
261QH0700X
Hearing and Speech Clinic/Center
—
—
261QX0100X
Occupational Medicine Clinic/Center
—
—
Other
Enumeration date
10/12/2022
Last updated
10/12/2022
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