Organization
DENVER SOURCE, LLC
Active
Parent organization
DENVER SOURCE, LLC
Organization subpart
Yes
Provider details
NPI number
Legal business name
DENVER SOURCE, LLC
Authorized official
MR. JOHN PIERCE DICKEY BA, MHA (DIRECTOR/CEO)
(720) 597-0366
Entity
Organization
Contact information
Practice address
1525 W PARKHILL AVE, LITTLETON, CO 80120-2614
(720) 291-7230
Mailing address
1525 W PARKHILL AVE, LITTLETON, CO 80120-2614
(720) 291-7230
Taxonomy
Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
—
—
251C00000X
Developmentally Disabled Services Day Training Agency
—
—
320600000X
Intellectual and/or Developmental Disabilities Residential Treatment Facility
—
—
320700000X
Physical Disabilities Residential Treatment Facility
—
—
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
Primary
—
—
322D00000X
Emotionally Disturbed Childrens' Residential Treatment Facility
—
—
347C00000X
Private Vehicle
—
—
Other
Enumeration date
09/13/2017
Last updated
07/21/2022
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