Organization
DEVELOPMENTAL DISABILITIES CENTER
Active
Other names
Imagine
Organization subpart
No
Provider details
NPI number
Authorized official
ROBIN GREY (CFO)
(303) 641-6342
Entity
Organization
Contact information
Practice address
1400 DIXON AVE, LAFAYETTE, CO 80026
(303) 665-7789
Mailing address
1400 DIXON AVE, LAFAYETTE, CO 80026-2790
(303) 665-7789
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
42800145
—
CO
Enumeration date
05/19/2021
Last updated
11/01/2024
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