Healthcare Provider Details

I. General information

NPI: 1780868224
Provider Name (Legal Business Name): SPECIAL NEEDS NETWORK
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/19/2007
Last Update Date: 03/16/2023
Certification Date: 03/16/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6612 FIG ST # 103
ARVADA CO
80004-1044
US

IV. Provider business mailing address

6612 FIG ST UNIT 103
ARVADA CO
80004-1027
US

V. Phone/Fax

Practice location:
  • Phone: 303-403-9169
  • Fax: 303-431-2766
Mailing address:
  • Phone: 303-403-9169
  • Fax: 303-431-2766

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code335G00000X
TaxonomyMedical Foods Supplier
License Number
License Number State

VIII. Authorized Official

Name: SCOTT DOUGLAS FEAVEL
Title or Position: PRESIDENT
Credential:
Phone: 303-403-9169