Organization
LA MAR CHILD PLACEMNT AGENCY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. DENNIS LEE TAYLOR CEO (DIRECTOR)
(719) 391-5093
Entity
Organization
Contact information
Practice address
5315 HICKS DR, COLORADO SPRINGS, CO 80911-3615
(719) 391-5093
(719) 392-2541
Mailing address
5315 HICKS DR, COLORADO SPRINGS, CO 80911-3615
(719) 391-5093
(719) 392-2541
Taxonomy
Speciality
Code
Description
License number
State
320800000X
Mental Illness Community Based Residential Treatment Facility
Primary
1628285
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1628285
LICENSE NUMBER
CO
Enumeration date
07/26/2013
Last updated
07/26/2013
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