Healthcare Provider Details

I. General information

NPI: 1770490260
Provider Name (Legal Business Name): ANANEO COLORADO LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/27/2026
Last Update Date: 08/27/2026
Certification Date: 08/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9121 E 14TH AVE APT 106
AURORA CO
80010-3045
US

IV. Provider business mailing address

9121 E 14TH AVE APT 106
AURORA CO
80010-3045
US

V. Phone/Fax

Practice location:
  • Phone: 720-640-1080
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State

VIII. Authorized Official

Name: FLOYD YOUNG III
Title or Position: DIRECTOR OF STRATEGIC OPERATIONS
Credential:
Phone: 503-997-5635