Organization
INTERLACE LIVING LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. THOMAS EDWARD LAFAVE (OWNER)
(720) 496-9732
Entity
Organization
Contact information
Practice address
5912 S CODY ST STE 208, LITTLETON, CO 80123-9544
(720) 496-9732
Mailing address
5912 S CODY ST STE 208, LITTLETON, CO 80123-9544
(720) 496-9732
Taxonomy
Speciality
Code
Description
License number
State
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
Primary
—
—
Other
Enumeration date
09/18/2019
Last updated
09/18/2019
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