Healthcare Provider Details

I. General information

NPI: 1891610564
Provider Name (Legal Business Name): ASTRA MO BHE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/12/2026
Last Update Date: 08/12/2026
Certification Date: 08/12/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

117 S LEXINGTON ST STE 100
HARRISONVILLE MO
64701-2443
US

IV. Provider business mailing address

15620 MANCHESTER RD
ELLISVILLE MO
63011-2279
US

V. Phone/Fax

Practice location:
  • Phone: 919-200-0240
  • Fax:
Mailing address:
  • Phone: 919-200-0240
  • Fax: 919-375-6899

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code106E00000X
TaxonomyAssistant Behavior Analyst
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State

VIII. Authorized Official

Name: EITAN ADAMS
Title or Position: MANAGER
Credential:
Phone: 919-200-0240