Organization
OUR OWN LIVES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TARA D KIENE (PRESIDENT/CEO)
(970) 385-3443
Entity
Organization
Contact information
Practice address
325 S PINE ST, CORTEZ, CO 81321-3441
(970) 259-2464
(970) 259-2618
Mailing address
325 S PINE ST, CORTEZ, CO 81321-3441
(970) 259-2464
(970) 259-2618
Taxonomy
Speciality
Code
Description
License number
State
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
Primary
—
—
Other
Enumeration date
06/27/2023
Last updated
06/27/2023
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