Healthcare Provider Details

I. General information

NPI: 1144497975
Provider Name (Legal Business Name): COMMUNITY LIVING ALTERNATIVES, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/12/2008
Last Update Date: 06/14/2022
Certification Date: 06/14/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

14252 E EVANS AVE
AURORA CO
80014-1432
US

IV. Provider business mailing address

14252 E EVANS AVE
AURORA CO
80014-1432
US

V. Phone/Fax

Practice location:
  • Phone: 303-745-8015
  • Fax: 303-745-1126
Mailing address:
  • Phone: 303-745-8015
  • Fax: 303-745-1126

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code103TM1800X
TaxonomyIntellectual & Developmental Disabilities Psychologist
License NumberH2019
License Number StateCO
# 2
Primary TaxonomyN
Taxonomy Code251C00000X
TaxonomyDevelopmentally Disabled Services Day Training Agency
License NumberT2021
License Number StateCO
# 3
Primary TaxonomyN
Taxonomy Code251C00000X
TaxonomyDevelopmentally Disabled Services Day Training Agency
License NumberT2019
License Number StateCO
# 4
Primary TaxonomyN
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License NumberH2019
License Number StateCO
# 5
Primary TaxonomyN
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number StateCO
# 6
Primary TaxonomyY
Taxonomy Code320600000X
TaxonomyIntellectual and/or Developmental Disabilities Residential Treatment Facility
License NumberT2016
License Number StateCO
# 7
Primary TaxonomyN
Taxonomy Code320600000X
TaxonomyIntellectual and/or Developmental Disabilities Residential Treatment Facility
License Number
License Number State
# 8
Primary TaxonomyN
Taxonomy Code347E00000X
TaxonomyTransportation Broker
License NumberT2002
License Number StateCO
# 9
Primary TaxonomyN
Taxonomy Code385HR2060X
TaxonomyChild Intellectual and/or Developmental Disabilities Respite Care
License Number
License Number StateCO

VIII. Authorized Official

Name: MRS. BARBARA ANN KENYON-MOHRLANG
Title or Position: EXECUTIVE DIRECTOR
Credential:
Phone: 303-745-8015