Organization
INDIVIDUAL DYNAMICS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JOE VACCARO (DIRECTOR)
(720) 295-5559
Entity
Organization
Contact information
Practice address
6105 S MAIN ST, SUITE 200, AURORA, CO 80016-5360
(720) 295-5559
Mailing address
4575 GALLEY RD, SUITE 400A, COLORADO SPRINGS, CO 80915-2750
(720) 295-5559
Taxonomy
Speciality
Code
Description
License number
State
251C00000X
Developmentally Disabled Services Day Training Agency
—
—
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Enumeration date
10/21/2010
Last updated
10/30/2020
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