Organization
SHYANNE RICHARDSON MSW
Active
Other names
The Sidewalk Center
Organization subpart
No
Provider details
NPI number
Authorized official
SHYANNE RICHARDSON MSW (OWNER)
(303) 931-0932
Entity
Organization
Contact information
Practice address
895 LEWIS DR, LAKEWOOD, CO 80215-5724
(303) 931-0932
Mailing address
895 LEWIS DR, LAKEWOOD, CO 80215-5724
(303) 931-0932
Taxonomy
Speciality
Code
Description
License number
State
385HR2060X
Child Intellectual and/or Developmental Disabilities Respite Care
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
16738578
—
CO
Enumeration date
11/08/2016
Last updated
11/08/2016
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