Healthcare Provider Details

I. General information

NPI: 1912367632
Provider Name (Legal Business Name): CHOICE SERVICES OF COLORADO INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/24/2016
Last Update Date: 02/09/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5255 MARSHALL ST
ARVADA CO
80002-3924
US

IV. Provider business mailing address

720 ESHTON CT SE SUITE 100
COKATO MN
55321-4375
US

V. Phone/Fax

Practice location:
  • Phone: 303-371-6700
  • Fax:
Mailing address:
  • Phone: 952-994-9569
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251C00000X
TaxonomyDevelopmentally Disabled Services Day Training Agency
License Number32420838
License Number StateCO
# 2
Primary TaxonomyN
Taxonomy Code376J00000X
TaxonomyHomemaker
License Number
License Number State

VIII. Authorized Official

Name: RICHARD ALLEN SORENSEN
Title or Position: PRESIDENT
Credential:
Phone: 952-994-9572