Healthcare Provider Details
I. General information
NPI: 1134070105
Provider Name (Legal Business Name): BOLDNESS LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 02/05/2026
Last Update Date: 02/05/2026
Certification Date: 02/05/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
9748 DANUBE CT
COMMERCE CITY CO
80022-2415
US
IV. Provider business mailing address
9748 DANUBE CT
COMMERCE CITY CO
80022-2415
US
V. Phone/Fax
- Phone: 720-728-9327
- Fax:
- Phone: 720-728-9327
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 251C00000X |
| Taxonomy | Developmentally Disabled Services Day Training Agency |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 320900000X |
| Taxonomy | Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
MEDETINA
ADAGBA
Title or Position: DIRECTOR/OWNER
Credential:
Phone: 720-728-9327