Organization
COMMUNITY SERVICES & SUPPORTS
Active
Organization
COMMUNITY SERVICES & SUPPORTS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. KEVIN M GRAVES (PRESIDENT)
(719) 641-3827
Entity
Organization
Contact information
Practice address
4575 GALLEY RD., SUITE 400A, COLORADO SPRINGS, CO 80915
(719) 574-6101
Mailing address
4575 GALLEY RD STE 100D, COLORADO SPRINGS, CO 80915-2747
(719) 581-9778
Taxonomy
Speciality
Code
Description
License number
State
251C00000X
Developmentally Disabled Services Day Training Agency
—
—
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
Primary
—
—
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
376J00000X
Homemaker
—
—
385H00000X
Respite Care
—
—
Other
Enumeration date
10/21/2010
Last updated
03/25/2022
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