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Organization

DEVELOPMENTAL DISABILITIES CENTER

Active
Organization subpart
No

Provider details

NPI number
Authorized official
ROBIN GREY (CFO)
(303) 641-6342
Entity
Organization

Contact information

Practice address
4500 7TH ST, BOULDER, CO 80304-4394
(303) 665-7789
Mailing address
1400 DIXON AVE, LAFAYETTE, CO 80026-2790
(303) 665-7789

Taxonomy

Speciality
Code
Description
License number
State
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
09139650
CO
Enumeration date
08/25/2021
Last updated
10/19/2023
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