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Organization
COLORADO BOYS RANCH FOUNDATION
Active
Organization
COLORADO BOYS RANCH FOUNDATION
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TOM ROSE (CEO)
(303) 691-6095
Entity
Organization
Contact information
Practice address
12567 W CEDAR DR STE 210, LAKEWOOD, CO 80228-2009
(303) 691-6095
(303) 376-6372
Mailing address
12567 W CEDAR DR STE 210, LAKEWOOD, CO 80228-2009
(303) 691-6095
(303) 376-6372
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
251S00000X
Community/Behavioral Health Agency
—
—
261QM0850X
Adult Mental Health Clinic/Center
—
—
261QM0855X
Adolescent and Children Mental Health Clinic/Center
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000207250
—
VA
05
—
000E1265
—
NM
05
—
0016029700001
—
PA
05
—
034723300
—
DC
05
—
116119901
—
WY
05
—
1532032
—
CO
05
—
4101658
—
MT
05
—
8271909
—
NJ
05
—
HS375PI
—
AK
Enumeration date
02/22/2007
Last updated
05/03/2019
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