Healthcare Provider Details

I. General information

NPI: 1467876169
Provider Name (Legal Business Name): W, L, & J, L, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/16/2014
Last Update Date: 01/21/2022
Certification Date: 01/21/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4401 S QUEBEC ST
DENVER CO
80237-2684
US

IV. Provider business mailing address

4401 S QUEBEC ST
DENVER CO
80237-2684
US

V. Phone/Fax

Practice location:
  • Phone: 720-484-4996
  • Fax: 303-794-6494
Mailing address:
  • Phone: 720-484-4996
  • Fax: 303-794-6494

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code324500000X
TaxonomySubstance Abuse Rehabilitation Facility
License Number
License Number State

VIII. Authorized Official

Name: MR. ERIC W LAPP
Title or Position: CEO
Credential:
Phone: 720-840-8807