Healthcare Provider Details

I. General information

NPI: 1720649122
Provider Name (Legal Business Name): GOODWILL OF COLORADO
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/26/2019
Last Update Date: 07/31/2023
Certification Date: 07/31/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6850 FEDERAL BLVD
DENVER CO
80221-2628
US

IV. Provider business mailing address

6850 FEDERAL BLVD
DENVER CO
80221-2628
US

V. Phone/Fax

Practice location:
  • Phone: 303-650-7700
  • Fax:
Mailing address:
  • Phone: 303-650-7700
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code376J00000X
TaxonomyHomemaker
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code385H00000X
TaxonomyRespite Care
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code373H00000X
TaxonomyDay Training/Habilitation Specialist
License Number
License Number State

VIII. Authorized Official

Name: TAMARA TRUJILLO
Title or Position: DIRECTOR OF COMMUNITY PROGRAMS
Credential:
Phone: 719-635-4483