Organization
CBLG RESIDENTIAL SERVICES
Active
Parent organization
ELIZABETH OSTENDORF, LLC
Other names
Colorado Behavior and Learning Group
Organization subpart
Yes
Provider details
NPI number
Legal business name
ELIZABETH OSTENDORF, LLC
Authorized official
JACEY BOMAN (COMPLIANCE COORDINATOR)
(719) 466-4809
Entity
Organization
Contact information
Practice address
1511 SWOPE AVENUE, COLORADO SPRINGS, CO 80909-2846
(719) 466-4809
(719) 368-8399
Mailing address
2120 E LA SALLE STREET, COLORADO SPRINGS, CO 80909-2218
(719) 466-4809
(719) 368-8399
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
—
—
320600000X
Intellectual and/or Developmental Disabilities Residential Treatment Facility
—
—
Other
Enumeration date
06/15/2022
Last updated
11/04/2024
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