NPIMap

Organization Active NPI

Alta Vista Center for Autism

  • Behavior Analyst
  • Lakewood, CO
National Provider Identifier
1679199566
Registry record updated Jun 17, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior AnalystTaxonomy code 103K00000X
Legal business name
ALTA VISTA CENTER FOR AUTISM
Practice address
2001 Hoyt Street
Lakewood, CO 80215
Phone
(303) 759-1192
NPI assigned
Jun 17, 2020
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 17, 2020

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

Authorized official

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior AnalystGroup: 193200000X MULTI-SPECIALTY GROUP 103K00000X Primary
Speech-Language PathologistGroup: 193200000X MULTI-SPECIALTY GROUP 235Z00000X
Respite Care 385H00000X

Addresses

Primary practice location

2001 Hoyt Street
Lakewood, CO 80215

Mailing address

2001 Hoyt St.
Lakewood, CO 80215
Phone (303) 759-1192

Other identifiers 1

IdentifierTypeStateIssuer
92354050MedicaidCO

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

Other organizations with this tax ID 3

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

Locations

2001 Hoyt St
Lakewood, CO 80215
Phone (303) 759-1192

NPI Registry JSON

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

{
    "created_epoch": "1592352000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1592352000000",
    "number": "1679199566",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2001 HOYT ST.",
            "city": "LAKEWOOD",
            "state": "CO",
            "postal_code": "80215",
            "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": "2001 HOYT STREET",
            "city": "LAKEWOOD",
            "state": "CO",
            "postal_code": "80215",
            "telephone_number": "303-759-1192"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ALTA VISTA CENTER FOR AUTISM",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-06-17",
        "last_updated": "2020-06-17",
        "certification_date": "2020-06-17",
        "status": "A",
        "authorized_official_last_name": "WINN",
        "authorized_official_first_name": "KEN",
        "authorized_official_title_or_position": "CHIEF CLINICAL OFFICER",
        "authorized_official_telephone_number": "303-759-1192",
        "authorized_official_credential": "BCBA"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Behavior Analyst",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Speech-Language Pathologist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "385H00000X",
            "taxonomy_group": "",
            "desc": "Respite Care",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "92354050",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Firefly Autism",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Lakewood, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 17, 2020; 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.