| Bluegrass Center For Autism | |
|
9300 Cedar Center Way Ste 200 Louisville KY 40291-4522 | |
| (502) 473-7219 | |
| (502) 709-9892 |
| Full Name | Bluegrass Center For Autism |
|---|---|
| Speciality | Behavior Technician |
| Location | 9300 Cedar Center Way Ste 200, Louisville, Kentucky |
| Authorized Official Name and Position | Jennifer L Wilt (DIRECTOR) |
| Authorized Official Contact | 5024433836 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Bluegrass Center For Autism 9300 Cedar Center Way Ste 200 Louisville KY 40291-4522 Ph: (502) 473-7219 | Bluegrass Center For Autism 9300 Cedar Center Way Ste 200 Louisville KY 40291-4522 Ph: (502) 473-7219 |
| NPI Number | 1184423808 |
|---|---|
| Provider Enumeration Date | 03/13/2025 |
| Last Update Date | 03/13/2025 |
| Certification Date | 03/13/2025 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1184423808 | NPI | - | NPPES |
| 7100700160 | Medicaid | KY |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103K00000X | Behavior Analyst | (* (Not Available)) | Secondary |
| 106S00000X | Behavior Technician | (* (Not Available)) | Primary |
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