Organization
JACOB HOUSE
Active
Organization
JACOB HOUSE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. DAVID HOPE MITCHELL (OWNER)
(303) 525-6141
Entity
Organization
Contact information
Practice address
13420 W WARREN AVE, LAKEWOOD, CO 80228-4616
(303) 525-6141
Mailing address
13420 W WARREN AVE, LAKEWOOD, CO 80228-4616
(303) 525-6141
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
—
—
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
Primary
—
—
Other
Enumeration date
03/07/2018
Last updated
04/16/2018
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