Organization
GREAT PLAY OF HIGHLANDS RANCH
Active
Organization subpart
No
Provider details
NPI number
Authorized official
PONG PAUL HARNKIJROONG (OWNER)
(646) 416-1208
Entity
Organization
Contact information
Practice address
5690 E COUNTY LINE PL, UNIT D, HIGHLANDS RANCH, CO 80126
(646) 416-1208
Mailing address
5690 COUNTY LINE PL UNIT D, HIGHLANDS RANCH, CO 80126-3935
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Enumeration date
09/18/2017
Last updated
09/18/2017
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