Healthcare Provider Details

I. General information

NPI: 1578429585
Provider Name (Legal Business Name): COLLABORATIVE RESIDENTIAL SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/03/2026
Last Update Date: 01/03/2026
Certification Date: 01/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2851 S PARKER RD # 1-244
AURORA CO
80014-2736
US

IV. Provider business mailing address

2851 S PARKER RD # 1-244
AURORA CO
80014-2736
US

V. Phone/Fax

Practice location:
  • Phone: 720-400-6168
  • Fax: 720-400-6168
Mailing address:
  • Phone: 720-400-6168
  • Fax: 720-400-6168

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code251C00000X
TaxonomyDevelopmentally Disabled Services Day Training Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code343900000X
TaxonomyNon-emergency Medical Transport (VAN)
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code320900000X
TaxonomyIntellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
License Number
License Number State

VIII. Authorized Official

Name: MS. MELISSA UBALLE
Title or Position: EXECUTIVE DIRECTOR
Credential:
Phone: 720-400-6168