Healthcare Provider Details

I. General information

NPI: 1023658226
Provider Name (Legal Business Name): CENTER FOR PEOPLE WITH DISABILITIES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/15/2020
Last Update Date: 01/15/2020
Certification Date: 01/15/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1675 RANGE ST
BOULDER CO
80301-2722
US

IV. Provider business mailing address

1675 RANGE ST
BOULDER CO
80301-2722
US

V. Phone/Fax

Practice location:
  • Phone: 303-442-8662
  • Fax:
Mailing address:
  • Phone: 303-442-8662
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251B00000X
TaxonomyCase Management Agency
License Number
License Number State

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name: MARIA STEPANYAN
Title or Position: EXECUTIVE DIRECTOR
Credential:
Phone: 303-442-8662