Organization
EAGLE'S NEST GROUP CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MELANIE KENNEDY (CEO)
(303) 875-3238
Entity
Organization
Contact information
Practice address
93 RANCHETTES RD, BAILEY, CO 80421-2051
(303) 838-9900
(303) 838-9901
Mailing address
93 RANCHETTES RD, BAILEY, CO 80421-2051
(303) 838-9900
(303) 838-9901
Taxonomy
Speciality
Code
Description
License number
State
251C00000X
Developmentally Disabled Services Day Training Agency
—
—
320600000X
Intellectual and/or Developmental Disabilities Residential Treatment Facility
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
84700238
—
CO
Enumeration date
05/11/2017
Last updated
05/11/2017
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