MEDICARE: COMMONWORKS

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	251C00000X	Developmentally Disabled Services Day Training Agency

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1639252638
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	COMMONWORKS

Provider Business Mailing Address
First Line	:	4575 GALLEY RD
Second Line	:	SUITE 400A
City	:	COLORADO SPRINGS
State	:	CO
Zip	:	80915-2750
Country	:	US
Telephone Number	:	719-574-6101
Fax Number	:	719-574-6105

Provider Business Practice Location Address
First Line	:	1325 S COLORADO BLVD
Second Line	:	SUITE B 502
City	:	DENVER
State	:	CO
Zip	:	80222-3303
Country	:	US
Telephone Number	:	720-214-0830
Fax Number	:	720-214-0835

Authorized Official
Title or Position	:	PRESIDENT
Name	:	MR. KEVIN M GRAVES
Credential	:
Telephone Number	:	719-641-3827

Provider Enumeration Date	:	10/23/2006
Last Update Date	:	08/22/2020

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Directions to “COMMONWORKS ” Practice Location

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