Organization
EDH SUPPORT COMPANY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JANET POWELL HENDRICKS (EXECUTIVE DIRECTOR)
(303) 442-1308
Entity
Organization
Contact information
Practice address
1215 CEDAR AVE, 201, BOULDER, CO 80304-3157
(303) 442-1308
Mailing address
67 WILD HORSE CIR, BOULDER, CO 80304-0488
(303) 442-1308
Taxonomy
Speciality
Code
Description
License number
State
251C00000X
Developmentally Disabled Services Day Training Agency
Primary
—
—
Other
Enumeration date
09/02/2016
Last updated
09/02/2016
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