Organization
INTELLECTUAL DISABILITY SUPPORT INC
Active
Organization
INTELLECTUAL DISABILITY SUPPORT INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. ELSWORTH E DACRES (EXECUTIVE DIRECTOR)
(303) 547-2333
Entity
Organization
Contact information
Practice address
18199 E LASALLE PL, AURORA, CO 80013-5919
(720) 748-0907
Mailing address
PO BOX 472065, AURORA, CO 80047-2065
(720) 748-0907
Taxonomy
Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
—
—
251C00000X
Developmentally Disabled Services Day Training Agency
—
—
253J00000X
Foster Care Agency
—
—
320600000X
Intellectual and/or Developmental Disabilities Residential Treatment Facility
—
—
320700000X
Physical Disabilities Residential Treatment Facility
—
—
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
Primary
—
—
385H00000X
Respite Care
—
—
385HR2060X
Child Intellectual and/or Developmental Disabilities Respite Care
—
—
385HR2065X
Child Physical Disabilities Respite Care
—
—
Other
Enumeration date
01/14/2013
Last updated
01/14/2013
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