Organization
COMMUNITY ADVANTAGE, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. TIMOTHY WHOBREY (PROVIDER ENROLLMENT)
(502) 630-7249
Entity
Organization
Contact information
Practice address
1375 KEN PRATT BLVD, LONGMONT, CO 80501-6325
(303) 684-9833
Mailing address
805 N WHITTINGTON PKWY, LOUISVILLE, KY 40222-7101
(800) 866-0860
Taxonomy
Speciality
Code
Description
License number
State
251C00000X
Developmentally Disabled Services Day Training Agency
Primary
—
—
251S00000X
Community/Behavioral Health Agency
—
—
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
—
—
376J00000X
Homemaker
—
—
385HR2060X
Child Intellectual and/or Developmental Disabilities Respite Care
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
09146234
—
CO
Enumeration date
05/16/2007
Last updated
10/14/2020
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