Organization
AUTISM 360 SUPPORT LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. ELLEN JENNY SLATON LCSW (OWNER)
(562) 361-8578
Entity
Organization
Contact information
Practice address
5762 BOLSA AVE STE 107, HUNTINGTON BEACH, CA 92649-1172
(562) 361-8578
Mailing address
11278 LOS ALAMITOS BLVD # 106, LOS ALAMITOS, CA 90720-3958
(562) 396-5896
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
—
—
Other
Enumeration date
07/08/2022
Last updated
01/26/2023
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