Organization
MAXIM
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. TIMOTHY LAMARR BRENT SR. BA (MENTAL HEALTH AIDE)
(720) 324-3755
Entity
Organization
Contact information
Practice address
17908 E AMHERST AVE, AURORA, CO 80013-2122
(720) 324-3755
Mailing address
17908 E AMHERST AVE, AURORA, CO 80013-2122
(720) 324-3755
Taxonomy
Speciality
Code
Description
License number
State
320800000X
Mental Illness Community Based Residential Treatment Facility
Primary
—
—
Other
Enumeration date
06/18/2012
Last updated
06/18/2012
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