| Jumpstart Autism Center | |
|
8500 Washington St Ne Ste A1 Albuquerque NM 87113-1861 | |
| (505) 828-3837 | |
| (877) 828-1550 |
| Full Name | Jumpstart Autism Center |
|---|---|
| Speciality | Behavior Analyst |
| Location | 8500 Washington St Ne Ste A1, Albuquerque, New Mexico |
| Authorized Official Name and Position | Brian Russell Lopez (OWNER) |
| Authorized Official Contact | 5058283837 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Jumpstart Autism Center 8100 M4 Wyoming Ne #406 Albuquerque NM 87113-6615 Ph: (505) 828-3837 | Jumpstart Autism Center 8500 Washington St Ne Ste A1 Albuquerque NM 87113-1861 Ph: (505) 828-3837 |
| NPI Number | 1225206105 |
|---|---|
| Provider Enumeration Date | 02/13/2008 |
| Last Update Date | 04/21/2021 |
| Certification Date | 04/21/2021 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1225206105 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103K00000X | Behavior Analyst | (* (Not Available)) | Primary |
| 103TC2200X | Psychologist - Clinical Child & Adolescent | 0877 (New Mexico) | Secondary |
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