Organization
ROOTED 303
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. DOMINGO CRUZ (FOUNDER)
(303) 729-3681
Entity
Organization
Contact information
Practice address
5933 S FAIRFIED STREET, LITTLETON, CO 80120
(303) 729-3681
Mailing address
5933 S FAIRFIELD ST, LITTLETON, CO 80120-2821
(303) 729-3681
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
—
—
175T00000X
Peer Specialist
Primary
—
—
251S00000X
Community/Behavioral Health Agency
—
—
Other
Enumeration date
12/27/2022
Last updated
02/28/2024
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