Organization
GOODWILL OF COLORADO
Active
Other names
Your Life Your Way
Organization subpart
No
Provider details
NPI number
Authorized official
MS. KARLA A GRAZIER (CEO)
(719) 635-4483
Entity
Organization
Contact information
Practice address
1460 GARDEN OF THE GODS RD, COLORADO SPRINGS, CO 80907
(719) 635-4483
(719) 635-5713
Mailing address
1460 GARDEN OF THE GODS RD, COLORADO SPRINGS, CO 80907-3414
(719) 635-4483
(719) 635-5713
Taxonomy
Speciality
Code
Description
License number
State
251C00000X
Developmentally Disabled Services Day Training Agency
—
—
251E00000X
Home Health Agency
Primary
—
—
253Z00000X
In Home Supportive Care Agency
1005UO
CO
261QA0600X
Adult Day Care Clinic/Center
—
—
343900000X
Non-emergency Medical Transport (VAN)
—
—
373H00000X
Day Training/Habilitation Specialist
—
—
376J00000X
Homemaker
—
—
385H00000X
Respite Care
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1005UO
CLASS B LICENSE
CO
05
—
90129377
—
CO
Enumeration date
04/20/2007
Last updated
07/31/2023
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