Individual
MAMADOU D DIALLO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
11059 E BETHANY DR, SUIT 200, AURORA, CO, 80014, AURORA, CO 80014-2622
(303) 617-2300
Mailing address
1001 S HAVANA ST, UNIT 127, DENVER, CO 80012-2910
(347) 261-6452
Taxonomy
Speciality
Code
Description
License number
State
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
Primary
160600381
CO
Other
Enumeration date
03/30/2016
Last updated
03/30/2016
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