Healthcare Provider Details

I. General information

NPI: 1710762760
Provider Name (Legal Business Name): AD ASTRA AUTISM CENTERS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/29/2023
Last Update Date: 03/14/2025
Certification Date: 03/14/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1972 INNERBELT BUSINESS CENTER DR
OVERLAND MO
63114-5760
US

IV. Provider business mailing address

1218 OAK BOROUGH DR
BALLWIN MO
63021-8330
US

V. Phone/Fax

Practice location:
  • Phone: 636-579-2250
  • Fax:
Mailing address:
  • Phone: 636-579-2250
  • Fax:

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

VIII. Authorized Official

Name: MR. AKASH SARKAR
Title or Position: COFOUNDER
Credential:
Phone: 636-579-2500