Organization
INTEGRATED LIFE CHOICES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JUSTIN SOLOMON (DIRECTOR OF FINANCE)
(402) 742-0311
Entity
Organization
Contact information
Practice address
240 ELIZABETH ST STE H2, ELIZABETH, CO 80107-7546
(303) 646-4402
(303) 646-4403
Mailing address
PO BOX 80728, LINCOLN, NE 68501-0728
Taxonomy
Speciality
Code
Description
License number
State
251C00000X
Developmentally Disabled Services Day Training Agency
Primary
—
—
343900000X
Non-emergency Medical Transport (VAN)
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
36358851
—
CO
Enumeration date
01/10/2020
Last updated
01/10/2020
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