Healthcare Provider Details

I. General information

NPI: 1215004015
Provider Name (Legal Business Name): EASTER SEALS COLORADO
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/29/2006
Last Update Date: 08/25/2025
Certification Date: 08/25/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5755 W ALAMEDA AVE
LAKEWOOD CO
80226
US

IV. Provider business mailing address

940 WADSWORTH BLVD STE 120
LAKEWOOD CO
80214-4593
US

V. Phone/Fax

Practice location:
  • Phone: 303-233-1666
  • Fax: 303-233-1028
Mailing address:
  • Phone: 303-233-0166
  • Fax: 303-233-1028

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code385HR2050X
TaxonomyRespite Care Camp
License Number47762
License Number StateCO
# 2
Primary TaxonomyY
Taxonomy Code261QA0600X
TaxonomyAdult Day Care Clinic/Center
License Number
License Number StateCO

VIII. Authorized Official

Name: ROMAN KRAFCZYK
Title or Position: CEO
Credential:
Phone: 720-270-4279