Individual
MR. KEITH BERNARD MARCANTEL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.A., M.S., NCSP
Contact information
Practice address
2802 N NEVADA AVE, COLORADO SPRINGS, CO 80907-6201
(719) 471-4329
Mailing address
925 N BALDWIN ST, WOODLAND PARK, CO 80863-1374
(719) 330-5753
Taxonomy
Speciality
Code
Description
License number
State
251C00000X
Developmentally Disabled Services Day Training Agency
Primary
1376967885
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1376967885
SMART SCHOOLS PARTNERS NPI NUMBER
CO
01
—
251C00000X
SMART SCHOOLS PARTNERS TYPE OF BUSINESS
CO
Enumeration date
08/06/2014
Last updated
08/06/2014
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