Organization
DEVELOPMENTAL DISABILITIES CENTER
Active
Organization
DEVELOPMENTAL DISABILITIES CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LISA JOSEPH (ACCOUNTANT)
(303) 926-6407
Entity
Organization
Contact information
Practice address
1806 IRIS AVE, BOULDER, CO 80304-2235
(303) 665-7789
Mailing address
1400 DIXON AVE, LAFAYETTE, CO 80026-2790
(303) 665-7789
Taxonomy
Speciality
Code
Description
License number
State
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
29315522
—
CO
Enumeration date
09/10/2021
Last updated
09/10/2021
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