Organization
ALTA VISTA CENTER FOR AUTISM
Active
Parent organization
ALTA VISTA CENTER FOR AUTISM
Other names
Firefly Autism
Organization subpart
Yes
Provider details
NPI number
Legal business name
ALTA VISTA CENTER FOR AUTISM
Authorized official
KENNETH WINN BCBA (CHIEF CLINICAL OFFICER)
(303) 759-1192
Entity
Organization
Contact information
Practice address
740 GUNNISON AVE, SUITE 215, GRAND JUNCTION, CO 81501-3222
(303) 759-1192
(303) 759-1194
Mailing address
2695 S JERSEY ST, SUITE 215, DENVER, CO 80222-6321
(303) 759-1192
(303) 759-1194
Taxonomy
Speciality
Code
Description
License number
State
252Y00000X
Early Intervention Provider Agency
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
20770081
—
CO
Enumeration date
11/29/2016
Last updated
11/29/2016
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