Organization
ENVISION-CREATIVE SUPPORT FOR PEOPLE WITH DEVELOPMENTAL DISABILITIES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. MARYLU WALTON (EXECUTIVE DIRECTOR)
(970) 339-5360
Entity
Organization
Contact information
Practice address
1050 37TH ST, EVANS, CO 80620-2115
(970) 339-5360
(970) 330-2261
Mailing address
PO BOX 200069, EVANS, CO 80620-8657
(970) 339-5360
(970) 330-2261
Taxonomy
Speciality
Code
Description
License number
State
251C00000X
Developmentally Disabled Services Day Training Agency
Primary
—
—
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
—
—
376J00000X
Homemaker
—
—
385H00000X
Respite Care
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
09139676
—
CO
05
—
131920
—
CO
Enumeration date
03/21/2007
Last updated
11/21/2016
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