Healthcare Provider Details

I. General information

NPI: 1184561292
Provider Name (Legal Business Name): TALLGRASS ABA THERAPY LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/29/2026
Last Update Date: 04/29/2026
Certification Date: 04/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2750 1ST AVE NE STE 125A
CEDAR RAPIDS IA
52402-4831
US

IV. Provider business mailing address

2750 1ST AVE NE STE 125A
CEDAR RAPIDS IA
52402-4831
US

V. Phone/Fax

Practice location:
  • Phone: 319-319-9770
  • Fax:
Mailing address:
  • Phone: 319-319-9770
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number
License Number State

VIII. Authorized Official

Name: ASHER LAX
Title or Position: COMPLIANCE OFFICER
Credential:
Phone: 319-319-9770