Provider Demographics
NPI:1932773207
Name:STEP-IN AUTISM SERVICES OF ALASKA, L.L.C.
Entity Type:Organization
Organization Name:STEP-IN AUTISM SERVICES OF ALASKA, L.L.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:EMILY
Authorized Official - Middle Name:DIANE
Authorized Official - Last Name:ICE
Authorized Official - Suffix:
Authorized Official - Credentials:BCBA
Authorized Official - Phone:907-347-8115
Mailing Address - Street 1:16240 NORTHCLIFF PL
Mailing Address - Street 2:
Mailing Address - City:ELBERT
Mailing Address - State:CO
Mailing Address - Zip Code:80106-8863
Mailing Address - Country:US
Mailing Address - Phone:907-347-8115
Mailing Address - Fax:
Practice Address - Street 1:267 WASHINGTON ST
Practice Address - Street 2:
Practice Address - City:MONUMENT
Practice Address - State:CO
Practice Address - Zip Code:80132-9174
Practice Address - Country:US
Practice Address - Phone:719-451-7001
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:STEP-IN AUTISM SERVICES OF ALASKA, LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2021-05-19
Last Update Date:2021-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Single Specialty