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AUTISMWAVE THERAPY SERVICES, L.L.C.

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Company Details

Legal Name: AUTISMWAVE THERAPY SERVICES, L.L.C.
Jurisdiction: WASHINGTON
Entity Type: WA LIMITED LIABILITY COMPANY
Category: DOMESTIC ENTITY
Status: Administratively Dissolved
Formation/ Registration Date: August 16th 2021
Date of Dissolution: February 15th 2023
Expiration date: 31 Aug 2022
UBI Number: 604 798 729
ZIP code: 98042
City: Kent
County: KING
Home State: WASHINGTON
Principal Office Street Address: Google Maps Logo 13312 SE 262ND ST, KENT, WA, 98042-8521, UNITED STATES

Contact Details

E-Mail: SERVICES@AUTISMWAVETHERAPY.COM

Nature of Business

Health Care, Social Assistance & Service Organization

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Registered Agent Information

Name Role Address
AUTISMWAVE THERAPY SERVICES Registered Agent 13312 SE 262ND ST, KENT, WA, 98042-8521, UNITED STATES

Key Officers & Management

Name Role Address
SAMUEL BULLOCK Executor 3391 E PLUM ST, GILBERT, AZ, 85298-3000, UNITED STATES
MARIAM MZAHIM Executor 13312 SE 262ND ST, KENT, WA, 98042-8521, UNITED STATES
SAMUEL BULLOCK Governing Person -
MARIAM MZAHIM Governing Person -

National Provider Identifier

NPI Number:
1376219691
Certification Date:
2021-08-17

Authorized Person:

Name:
SAMUEL BULLOCK
Role:
COO
Phone:

Taxonomy:

Selected Taxonomy:
251S00000X - Community/Behavioral Health Agency
Is Primary:
Yes

Contacts:

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