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NPI Code Detail

MEDICARE: ALPINE AUTISM CENTER

MEDICARE: ALPINE AUTISM CENTER
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1251C00000XDevelopmentally Disabled Services Day Training Agency1546288CO
2385HR2060XChild Intellectual and/or Developmental Disabilities Respite Care1546288CO
3174400000XSpecialist

General Provider Information

NPI Number : 1225223126
Entity Type Code : Organization
Provider Name (Legal Business Name) : ALPINE AUTISM CENTER
Provider Business Mailing Address
First Line : 2760 FIELDSTONE RD
Second Line :
City : COLORADO SPRINGS
State : CO
Zip : 80919-3100
Country : US
Telephone Number : 719-203-6903
Fax Number :
Provider Business Practice Location Address
First Line : 2760 FIELDSTONE RD
Second Line :
City : COLORADO SPRINGS
State : CO
Zip : 80919-3100
Country : US
Telephone Number : 719-203-6903
Fax Number :
Authorized Official
Title or Position : BILLING COORDINATOR
Name : AARON CRUM
Credential :
Telephone Number : 719-203-6903
Provider Enumeration Date : 09/13/2007
Last Update Date : 01/31/2022

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