Organization
AUTISM BEHAVIOR CONSULTING GROUP, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
AMY WIECH BCBA (CLINICAL DIRECTOR)
(808) 277-7736
Entity
Organization
Contact information
Practice address
66-434 KAMEHAMEHA HIGHWAY, HALEIWA, HI 96712
(808) 277-7736
(808) 748-0202
Mailing address
PO BOX 1162, WAIALUA, HI 96791-1162
(808) 637-7736
(808) 748-0202
Taxonomy
Speciality
Code
Description
License number
State
251C00000X
Developmentally Disabled Services Day Training Agency
Primary
1041581
HI
251S00000X
Community/Behavioral Health Agency
1041581
HI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1245426865
TRICARE
—
Enumeration date
02/05/2010
Last updated
01/22/2014
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