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Individual

CHERYL K SISCO

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
B.S. CAC II

Contact information

Practice address
6860 W MISSISSIPPI AVE UNIT D, LAKEWOOD, CO 80226
(303) 975-1748
Mailing address
6860 W MISSISSIPPI AVE APT D, LAKEWOOD, CO 80226-4500
(303) 975-1748

Taxonomy

Speciality
Code
Description
License number
State
320800000X
Mental Illness Community Based Residential Treatment Facility
Primary
CO
324500000X
Substance Abuse Rehabilitation Facility

Other

Enumeration date
12/12/2012
Last updated
12/12/2012
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