Organization
CY-LESS RANCH
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. LESLIE COLLINS-POTTEBAUM (OWNER)
(303) 423-4424
Entity
Organization
Contact information
Practice address
16155 W 74TH DR, ARVADA, CO 80007-7828
(303) 423-4424
Mailing address
16155 W 74TH DR, ARVADA, CO 80007-7828
(303) 423-4424
Taxonomy
Speciality
Code
Description
License number
State
320600000X
Intellectual and/or Developmental Disabilities Residential Treatment Facility
Primary
050416
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
55580769
—
CO
Enumeration date
08/12/2010
Last updated
08/12/2010
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