Organization
ALTA VISTA CENTER FOR AUTISM
Active
Other names
DBA Firefly Autism
Organization subpart
No
Provider details
NPI number
Authorized official
KENNETH WINN BCBA (CHIEF CLINICAL OFFICER)
(303) 759-1192
Entity
Organization
Contact information
Practice address
2001 HOYT ST, LAKEWOOD, CO 80215-1639
(303) 759-1192
(303) 759-1194
Mailing address
2001 HOYT ST, LAKEWOOD, CO 80215-1639
(303) 759-1192
(303) 759-1194
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
—
—
252Y00000X
Early Intervention Provider Agency
Primary
1531305
CO
385H00000X
Respite Care
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
17770106
—
CO
Enumeration date
05/15/2008
Last updated
03/10/2021
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