| NPI | 1952804254 |
|---|---|
| Former Legal Business Name | NO |
| Entity Type | Organization |
| Authorized Contact | JUNOU CHENG Owner 303-570-3053 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320900000X Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities |
| Enumeration Date | 2018-03-13 |
| Last Update Date | 2019-04-22 |