Organization
SUPPORT MANAGEMENT
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. KEVIN M GRAVES (PRESIDENT/COO)
(719) 641-3827
Entity
Organization
Contact information
Practice address
11059 E BETHANY DR STE 150, DENVER, CO 80014-2637
(720) 748-0101
Mailing address
4575 GALLEY RD STE 100D, COLORADO SPRINGS, CO 80915-2747
(720) 295-6234
Taxonomy
Speciality
Code
Description
License number
State
251C00000X
Developmentally Disabled Services Day Training Agency
Primary
—
—
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
—
—
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
385H00000X
Respite Care
—
—
Other
Enumeration date
10/20/2010
Last updated
03/25/2022
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