Healthcare Provider Details

I. General information

NPI: 1619827250
Provider Name (Legal Business Name): MAVERICK LIVING LTD.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/02/2026
Last Update Date: 02/02/2026
Certification Date: 02/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1525 W NEVADA PL
DENVER CO
80223-1905
US

IV. Provider business mailing address

1525 W NEVADA PL
DENVER CO
80223-1905
US

V. Phone/Fax

Practice location:
  • Phone: 435-258-8236
  • Fax: 720-617-8008
Mailing address:
  • Phone: 435-258-8236
  • Fax: 720-617-8008

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code251C00000X
TaxonomyDevelopmentally Disabled Services Day Training Agency
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code320900000X
TaxonomyIntellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
License Number
License Number State

VIII. Authorized Official

Name: STRATTON CAPUTO
Title or Position: DIRECTOR
Credential: BCBA
Phone: 435-258-8236