NPIMap

Organization Active NPI

Alta Vista Center for Autism

Doing business as Firefly Autism

  • Early Intervention Provider Agency
  • Grand Junction, CO
National Provider Identifier
1346783024
Registry record updated Nov 29, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Early Intervention Provider AgencyTaxonomy code 252Y00000X
Legal business name
ALTA VISTA CENTER FOR AUTISM
Doing business as
Firefly Autism
Practice address
740 Gunnison Ave
Suite 215
Grand Junction, CO 81501-3222
Phone
(303) 759-1192
Fax
(303) 759-1194
NPI assigned
Nov 29, 2016
Last updated
Nov 29, 2016By the provider in NPPES
Organization subpart
Yes
Parent organization
ALTA VISTA CENTER FOR AUTISMAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Nov 29, 2016

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

Authorized official

Name
Kenneth Winn, BCBA
Title
Chief Clinical Officer
Phone
(303) 759-1192

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Early Intervention Provider Agency 252Y00000X NU Primary

Addresses

Primary practice location

740 Gunnison Ave
Suite 215
Grand Junction, CO 81501-3222

Mailing address

2695 S Jersey St
Suite 215
Denver, CO 80222-6321
Phone (303) 759-1192

Other identifiers 1

IdentifierTypeStateIssuer
20770081MedicaidCO

Other names 1

  • Firefly Autism Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Alta Vista Center for Autism4 organizations share this tax ID, including this one
Part of
Alta Vista Center for Autism

Other organizations with this tax ID 3

Organizations that report the same tax identification number in the National Provider Directory.

Locations

2695 S Jersey St
Ste 215
Denver, CO 80222

740 Gunnison Ave
Ste 215
Grand Junction, CO 81501
Phone (303) 759-1192

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1480377600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1480377600000",
    "number": "1346783024",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2695 S JERSEY ST",
            "address_2": "SUITE 215",
            "city": "DENVER",
            "state": "CO",
            "postal_code": "802226321",
            "telephone_number": "303-759-1192",
            "fax_number": "303-759-1194"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "740 GUNNISON AVE",
            "address_2": "SUITE 215",
            "city": "GRAND JUNCTION",
            "state": "CO",
            "postal_code": "815013222",
            "telephone_number": "303-759-1192",
            "fax_number": "303-759-1194"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ALTA VISTA CENTER FOR AUTISM",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "ALTA VISTA CENTER FOR AUTISM",
        "enumeration_date": "2016-11-29",
        "last_updated": "2016-11-29",
        "status": "A",
        "authorized_official_last_name": "WINN",
        "authorized_official_first_name": "KENNETH",
        "authorized_official_title_or_position": "CHIEF CLINICAL OFFICER",
        "authorized_official_telephone_number": "303-759-1192",
        "authorized_official_credential": "BCBA"
    },
    "taxonomies": [
        {
            "code": "252Y00000X",
            "taxonomy_group": "",
            "desc": "Early Intervention Provider Agency",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "20770081",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Firefly Autism",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Grand Junction, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 29, 2016; 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.