Organization
DEVELOPMENTAL DISABILITIES CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ROBIN GREY (CFO)
(303) 641-6342
Entity
Organization
Contact information
Practice address
1608 OTIS DR, LONGMONT, CO 80504-1765
(303) 665-7789
Mailing address
1400 DIXON AVE, LAFAYETTE, CO 80026-2790
(303) 665-7789
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
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
26185032
—
CO
Enumeration date
08/25/2021
Last updated
10/19/2023
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