Organization
1QUALITY LIFE
Active
Other names
Quality Life Service L.L.C.
Organization subpart
No
Provider details
NPI number
Authorized official
MR. EUGENE A. VAN BLARICOM BACHELOR OF SCIENCE (DIRECTOR OWNER)
(303) 439-2122
Entity
Organization
Contact information
Practice address
11975 REED ST, SUITE 1, BROOMFIELD, CO 80020-2814
(303) 439-2122
(303) 439-2622
Mailing address
11975 REED STREET, SUITE 1, BROOMFIELD, CO 80020-2815
(303) 439-2122
(303) 439-2622
Taxonomy
Speciality
Code
Description
License number
State
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
Primary
32066
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0147588
—
CO
Enumeration date
02/12/2007
Last updated
06/13/2008
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