Organization
DEVELOPMENTAL DISABILITIES CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LISA JOSEPH (ACCOUNTANT)
(303) 926-6407
Entity
Organization
Contact information
Practice address
435 MANHATTAN DR, BOULDER, CO 80303-4104
(303) 665-7789
Mailing address
1400 DIXON AVE, LAFAYETTE, CO 80026-2790
(303) 665-7789
Taxonomy
Speciality
Code
Description
License number
State
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
09144296
—
CO
Enumeration date
08/25/2021
Last updated
08/25/2021
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