Provider Demographics
NPI:1295542272
Name:JOURNEY FORWARD AUTISM LLC
Entity type:Organization
Organization Name:JOURNEY FORWARD AUTISM LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CO-OWNER
Authorized Official - Prefix:
Authorized Official - First Name:BOBETTE
Authorized Official - Middle Name:
Authorized Official - Last Name:READY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:702-482-8387
Mailing Address - Street 1:PO BOX 371855
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89137-1855
Mailing Address - Country:US
Mailing Address - Phone:702-482-8387
Mailing Address - Fax:702-781-3252
Practice Address - Street 1:6800 W CHEYENNE AVE
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89108-4590
Practice Address - Country:US
Practice Address - Phone:702-482-8387
Practice Address - Fax:702-781-3252
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-12-13
Last Update Date:2024-12-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Single Specialty