Organization
MK LEGACY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CHARLOTTE MCCLANAHAN (AGENCY DIRECTOR)
(719) 203-1892
Entity
Organization
Contact information
Practice address
422 E VERMIJO AVE STE G16, COLORADO SPRINGS, CO 80903-3791
(719) 203-1892
Mailing address
422 E VERMIJO AVE STE G16, COLORADO SPRINGS, CO 80903-3791
(719) 203-1892
Taxonomy
Speciality
Code
Description
License number
State
251C00000X
Developmentally Disabled Services Day Training Agency
Primary
—
—
Other
Enumeration date
10/25/2017
Last updated
06/16/2018
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