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Organization

COMPREHENSIVE COMMUNITY BASED SERVICES

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. NICHOLAS ROBERT DECILLA ED.D (EXECUTIVE DIRECTOR)
(303) 671-6042
Entity
Organization

Contact information

Practice address
8668 E DOANE PL, DENVER, CO 80231-4544
(303) 671-6042
Mailing address
8668 E DOANE PL, DENVER, CO 80231-4544
(303) 671-6042

Taxonomy

Speciality
Code
Description
License number
State
251C00000X
Developmentally Disabled Services Day Training Agency
Primary
CO

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
04079264
CO
Enumeration date
04/21/2016
Last updated
04/21/2016
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