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Organization

EXCELSIOR YOUTH CENTER

Active
Organization subpart
No

Provider details

NPI number
Authorized official
JOAN GABRIELSON (DIRECTOR)
(303) 693-1550
Entity
Organization

Contact information

Practice address
15001 E OXFORD AVE, AURORA, CO 80014-4186
(303) 693-1550
(303) 693-8309
Mailing address
15001 E OXFORD AVE, AURORA, CO 80014-4186
(303) 693-1550
(303) 693-8309

Taxonomy

Speciality
Code
Description
License number
State
320800000X
Mental Illness Community Based Residential Treatment Facility
Primary
45243
CO

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
53239873
CO
Enumeration date
02/28/2011
Last updated
02/28/2011
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