Organization
DEVELOPMENTAL DISABILITIES CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ROBIN GREY (COO AND CFO)
(303) 641-6342
Entity
Organization
Contact information
Practice address
1400 DIXON AVE, LAFAYETTE, CO 80026-2790
(303) 665-7789
Mailing address
1400 DIXON AVE, LAFAYETTE, CO 80026-2790
(303) 665-7789
Taxonomy
Speciality
Code
Description
License number
State
251C00000X
Developmentally Disabled Services Day Training Agency
Primary
—
—
261QR0400X
Rehabilitation Clinic/Center
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00155098
MEDICAID PROVIDER ID
CO
05
—
38915537
—
CO
Enumeration date
10/14/2021
Last updated
09/11/2024
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