Radiant Autism & Behavioral Services LLC

Primary specialty

Community/Behavioral Health AgencyTaxonomy code 251S00000X

Legal business name

RADIANT AUTISM & BEHAVIORAL SERVICES LLC

Practice address

2225 Summer Dr
El Dorado Hills, CA 95762-6304

Phone

(408) 609-0245

NPI assigned

Feb 10, 2018

Last updated

Feb 10, 2018By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Jonathan M Bliss

Title

Managing Member

Phone

(408) 609-0245

Specialties & licenses 3

Addresses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1518220800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1518220800000",
    "number": "1154820678",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2225 SUMMER DR",
            "city": "EL DORADO HILLS",
            "state": "CA",
            "postal_code": "957626304",
            "telephone_number": "408-609-0245"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2225 SUMMER DR",
            "city": "EL DORADO HILLS",
            "state": "CA",
            "postal_code": "957626304",
            "telephone_number": "408-609-0245"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RADIANT AUTISM & BEHAVIORAL SERVICES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-02-10",
        "last_updated": "2018-02-10",
        "status": "A",
        "authorized_official_last_name": "BLISS",
        "authorized_official_first_name": "JONATHAN",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "MANAGING MEMBER",
        "authorized_official_telephone_number": "408-609-0245"
    },
    "taxonomies": [
        {
            "code": "261QD1600X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Developmental Disabilities",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "252Y00000X",
            "taxonomy_group": "",
            "desc": "Early Intervention Provider Agency",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 10, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.