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Organization

KAAUM ENTERPRISES

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MR. JAMES ERNEST EDWARD MOORE BA (CEO/DIRECTOR OF DP OPERATIONS)
(719) 580-8810
Entity
Organization

Contact information

Practice address
155 PRINTERS PARKWAY, COLORADO SPRINGS, CO 80910-6100
(719) 396-3008
Mailing address
12728 WHEELER PEAK DR, PEYTON, CO 80831-8368
(719) 580-8810

Taxonomy

Speciality
Code
Description
License number
State
261QD1600X
Developmental Disabilities Clinic/Center
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
54125031
CO
Enumeration date
09/17/2018
Last updated
03/25/2022
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