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General NPI Number Information
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NPI Number | 1922708478
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Entity Type | Organization
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Legal Business Name | ATLAS AUTISM HEALTH MISSOURI LLC
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Dates
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Enumeration Date | 03/03/2023
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Last Update Date | 12/30/2024
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Provider Practice Location Address
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Address Line | 800 CHERRY ST LOWR SUITES
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City | COLUMBIA
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State | MO
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Zip | 65201-4824
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Country | US
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Telephone | 573-200-6745
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Fax |
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Provider Business Mailing Address
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Address Line | 800 CHERRY ST LOWR SUITES
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City | COLUMBIA
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State | MO
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Zip | 65201-4824
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Country | US
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Telephone | 573-200-6745
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | ABISHEK THIAGARAJ
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Credential |
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Telephone | 248-943-8811
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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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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Taxonomy #2
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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 #3
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Taxonomy Code | 261QM0855X
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Taxonomy Name | Adolescent and Children Mental Health Clinic/Center
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License Number |
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License Number State |
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