Provider Demographics
NPI:1184919227
Name:A.G.E.S. LEARNING SOLUTIONS, LLC
Entity type:Organization
Organization Name:A.G.E.S. LEARNING SOLUTIONS, LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CBO
Authorized Official - Prefix:
Authorized Official - First Name:EMMYLOU
Authorized Official - Middle Name:
Authorized Official - Last Name:SANTOS
Authorized Official - Suffix:
Authorized Official - Credentials:BCBA,LBA
Authorized Official - Phone:866-375-2437
Mailing Address - Street 1:2007 W HEDDING ST STE 201
Mailing Address - Street 2:
Mailing Address - City:SAN JOSE
Mailing Address - State:CA
Mailing Address - Zip Code:95128-1428
Mailing Address - Country:US
Mailing Address - Phone:866-375-2437
Mailing Address - Fax:866-375-2437
Practice Address - Street 1:2007 W HEDDING ST STE 201
Practice Address - Street 2:
Practice Address - City:SAN JOSE
Practice Address - State:CA
Practice Address - Zip Code:95128-1428
Practice Address - Country:US
Practice Address - Phone:866-375-2437
Practice Address - Fax:866-375-2437
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-06-16
Last Update Date:2024-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
251S00000X, 252Y00000X
CA1095003103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Single Specialty
No251S00000XAgenciesCommunity/Behavioral HealthGroup - Single Specialty
No252Y00000XAgenciesEarly Intervention Provider AgencyGroup - Single Specialty