| Alta Vista Center For Autism | |
|
2320 W Colorado Ave Ste 125 Colorado Springs CO 80904-3355 | |
| (303) 759-1192 | |
| (303) 759-1194 |
| Full Name | Alta Vista Center For Autism |
|---|---|
| Speciality | Behavior Analyst |
| Location | 2320 W Colorado Ave Ste 125, Colorado Springs, Colorado |
| Authorized Official Name and Position | Jesse Kirker Ogas (EXECUTIVE DIRECTOR) |
| Authorized Official Contact | 7203999203 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Alta Vista Center For Autism 2001 Hoyt St Lakewood CO 80215-1639 Ph: (303) 759-1192 | Alta Vista Center For Autism 2320 W Colorado Ave Ste 125 Colorado Springs CO 80904-3355 Ph: (303) 759-1192 |
| NPI Number | 1417531849 |
|---|---|
| Provider Enumeration Date | 05/11/2021 |
| Last Update Date | 05/11/2021 |
| Certification Date | 05/11/2021 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1417531849 | NPI | - | NPPES |
| 17770106 | Medicaid | CO |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103K00000X | Behavior Analyst | (* (Not Available)) | Primary |
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