Healthcare Provider Details

I. General information

NPI: 1598288151
Provider Name (Legal Business Name): YELLOW BIRD COMMUNITY CENTER, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/25/2017
Last Update Date: 07/25/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1010 JOLIET ST
AURORA CO
80010-4048
US

IV. Provider business mailing address

1010 JOLIET ST
AURORA CO
80010-4048
US

V. Phone/Fax

Practice location:
  • Phone: 720-541-8992
  • Fax:
Mailing address:
  • Phone: 201-916-6352
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251C00000X
TaxonomyDevelopmentally Disabled Services Day Training Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code347C00000X
TaxonomyPrivate Vehicle
License Number
License Number State

VIII. Authorized Official

Name: ALLYSON CASTELLI
Title or Position: OWNER AND MANAGING DIRECTOR
Credential:
Phone: 201-916-6352