Provider Demographics
NPI:1063025195
Name:ASCEND ABA COLORADO LLC
Entity Type:Organization
Organization Name:ASCEND ABA COLORADO LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:BRADLEY
Authorized Official - Middle Name:R
Authorized Official - Last Name:CHAMPLIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:913-706-5149
Mailing Address - Street 1:5545 WILSON RD
Mailing Address - Street 2:
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80919-3530
Mailing Address - Country:US
Mailing Address - Phone:913-706-5149
Mailing Address - Fax:
Practice Address - Street 1:1930 FREQUENT FLYER PT
Practice Address - Street 2:
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80915-1500
Practice Address - Country:US
Practice Address - Phone:800-345-0448
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-08-28
Last Update Date:2020-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Single Specialty