Healthcare Provider Details

I. General information

NPI: 1275461014
Provider Name (Legal Business Name): TIA PACE
Entity Type: Individual
Gender:
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/12/2026
Last Update Date: 08/18/2026
Certification Date: 08/18/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3768 NORWOOD DR STE 200-201
LITTLETON CO
80125-9710
US

IV. Provider business mailing address

3768 NORWOOD DR STE 200-201
LITTLETON CO
80125-9710
US

V. Phone/Fax

Practice location:
  • Phone: 720-367-0043
  • Fax:
Mailing address:
  • Phone: 480-367-0043
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: