Organization
MY SECOND HOME
Active
Other names
Megan's Place, LLC
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. KRISTIN N SMOCK (DIRECTOR OF OPERATIONS)
(720) 427-1979
Entity
Organization
Contact information
Practice address
6175 W 38TH AVE, WHEAT RIDGE, CO 80033-5146
(303) 881-4988
(303) 237-1043
Mailing address
6175 W 38TH AVE, WHEAT RIDGE, CO 80033-5146
(303) 881-4988
(303) 237-1043
Taxonomy
Speciality
Code
Description
License number
State
385HR2050X
Respite Care Camp
1655048
CO
385HR2060X
Child Intellectual and/or Developmental Disabilities Respite Care
Primary
1655048
CO
385HR2065X
Child Physical Disabilities Respite Care
1655048
CO
Other
Enumeration date
04/26/2016
Last updated
04/26/2016
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