| NPI | 1699217984 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHINALL GATSON VAN ROSS Individual Residential Provider 720-447-2908 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD1600X Clinic/Center, Developmental Disabilities |
| Additional Taxonomies | 320900000X Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities |
| 376J00000X Homemaker | |
| 385H00000X Respite Care | |
| Enumeration Date | 2016-11-17 |
| Last Update Date | 2022-07-21 |