Organization
ITHRIVE SUPPORT SERVICES 'LLC'
Active
Organization subpart
No
Provider details
NPI number
Authorized official
GRACE NAYO (DIRECTOR)
(732) 895-1130
Entity
Organization
Contact information
Practice address
17381 E 95TH AVE, COMMERCE CITY, CO 80022-7223
(732) 895-1130
Mailing address
17381 E 95TH AVE, COMMERCE CITY, CO 80022-7223
(732) 895-1130
Taxonomy
Speciality
Code
Description
License number
State
251C00000X
Developmentally Disabled Services Day Training Agency
—
—
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
Primary
—
—
Other
Enumeration date
06/25/2020
Last updated
05/17/2022
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