Organization
KEY TO LIFE COUNSELING CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. KEITH DEMEL PONTIFLET BA, CAC III (EXCUTIVE DIRECTOR)
(303) 865-3485
Entity
Organization
Contact information
Practice address
14231 E 4TH AVE, BLD 0NE SUITE 370, AURORA, CO 80011-8734
(303) 856-3485
(303) 856-3175
Mailing address
14231 EAST 4TH AVE, BLD 0NE SUITE 370, AURORA, CO 80011-9048
(303) 856-3485
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
ADAD #162901
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
ADAD LICENSE #162901
ADAD LICENSE #162901; CAC III LICENSE #6578
CO
Enumeration date
05/07/2008
Last updated
07/24/2014
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