Organization
DEVELOPMENTAL DISABILITIES CENTER
Active
Other names
Imagine
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JOHN NEVINS (CFO)
(303) 665-7789
Entity
Organization
Contact information
Practice address
1400 DIXON AVENUE, LAFAYETTE, CO 80026-2790
(303) 665-7789
(303) 665-2648
Mailing address
1400 DIXON AVENUE, LAFAYETTE, CO 80026-2790
(303) 665-7789
(303) 665-2648
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
—
—
103TB0200X
Cognitive & Behavioral Psychologist
—
—
1041C0700X
Clinical Social Worker
—
—
163W00000X
Registered Nurse
—
—
2084P0005X
Neurodevelopmental Disabilities Physician
—
—
2084P0800X
Psychiatry Physician
Primary
—
—
Other
Enumeration date
08/07/2006
Last updated
01/16/2008
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