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Organization
ALTA VISTA CENTER FOR AUTISM
Active
Organization
ALTA VISTA CENTER FOR AUTISM
Active
Other names
Firefly Autism
Organization subpart
No
Provider details
NPI number
Authorized official
KEN WINN BCBA (CHIEF CLINICAL OFFICER)
(303) 759-1192
Entity
Organization
Contact information
Practice address
2001 HOYT STREET, LAKEWOOD, CO 80215
(303) 759-1192
Mailing address
2001 HOYT ST., LAKEWOOD, CO 80215
(303) 759-1192
(303) 759-1194
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
—
—
235Z00000X
Speech-Language Pathologist
—
—
385H00000X
Respite Care
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
92354050
—
CO
Enumeration date
06/17/2020
Last updated
06/17/2020
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