Provider Demographics
NPI:1568070597
Name:COLO SPRINGS ABA LLC
Entity Type:Organization
Organization Name:COLO SPRINGS ABA LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:COLO SPRINGS ABA OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ADAM
Authorized Official - Middle Name:
Authorized Official - Last Name:WOODMAN
Authorized Official - Suffix:
Authorized Official - Credentials:MSED, BCBA
Authorized Official - Phone:719-257-3251
Mailing Address - Street 1:5412 BUTTERFIELD DR
Mailing Address - Street 2:
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80923-8719
Mailing Address - Country:US
Mailing Address - Phone:860-978-2685
Mailing Address - Fax:
Practice Address - Street 1:5412 BUTTERFIELD DR
Practice Address - Street 2:
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80923-8719
Practice Address - Country:US
Practice Address - Phone:860-978-2685
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-07-15
Last Update Date:2020-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Single Specialty