| NPI | 1356950679 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | NATHAN MWADIAMBALA LUKATE Director 720-288-3979 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320900000X Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities |
| Additional Taxonomies | 251C00000X |
| Enumeration Date | 2020-07-23 |
| Last Update Date | 2020-07-23 |