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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