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General NPI Number Information
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NPI Number | 1699473520
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Entity Type | Organization
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Legal Business Name | COLORADO SPRINGS ABA THERAPY LLC
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Dates
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Enumeration Date | 02/20/2023
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Last Update Date | 02/20/2023
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Provider Practice Location Address
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Address Line | 7900 E UNION AVE STE 1100
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City | DENVER
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State | CO
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Zip | 80237-2746
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Country | US
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Telephone | 719-602-2629
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Fax |
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Provider Business Mailing Address
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Address Line | 330 E COSTILLA ST # 1024
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City | COLORADO SPRINGS
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State | CO
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Zip | 80903-2106
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Country | US
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Telephone | 719-602-2629
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | VLADIMIR KOGAN
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Credential |
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Telephone | 646-598-7765
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QD1600X
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Taxonomy Name | Developmental Disabilities Clinic/Center
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 103K00000X
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Taxonomy Name | Behavior Analyst
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License Number |
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License Number State |
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