Provider Demographics
NPI:1750964862
Name:AD ASTRA BEHAVIOR ANALYTIC SERVICES
Entity type:Organization
Organization Name:AD ASTRA BEHAVIOR ANALYTIC SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:ALFREDO
Authorized Official - Middle Name:
Authorized Official - Last Name:MONTIEL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:657-233-1804
Mailing Address - Street 1:2093 PHILADELPHIA PIKE # 9173
Mailing Address - Street 2:
Mailing Address - City:CLAYMONT
Mailing Address - State:DE
Mailing Address - Zip Code:19703-2424
Mailing Address - Country:US
Mailing Address - Phone:657-233-1804
Mailing Address - Fax:
Practice Address - Street 1:6 CENTERPOINT DRIVE SUITE 700
Practice Address - Street 2:
Practice Address - City:LA PALMA
Practice Address - State:CA
Practice Address - Zip Code:92845
Practice Address - Country:US
Practice Address - Phone:657-233-1804
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-05-05
Last Update Date:2021-05-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Multi-Specialty