Healthcare Provider Details

I. General information

NPI: 1386284461
Provider Name (Legal Business Name): INTEGRATED LIFE CHOICES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/07/2020
Last Update Date: 05/20/2025
Certification Date: 05/20/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7800 S ELATI ST STE 111
LITTLETON CO
80120-4400
US

IV. Provider business mailing address

PO BOX 80728
LINCOLN NE
68501-0728
US

V. Phone/Fax

Practice location:
  • Phone: 303-484-8990
  • Fax: 303-484-8676
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251C00000X
TaxonomyDevelopmentally Disabled Services Day Training Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code320900000X
TaxonomyIntellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code343900000X
TaxonomyNon-emergency Medical Transport (VAN)
License Number
License Number State

VIII. Authorized Official

Name: JUSTIN SOLOMON
Title or Position: CHIEF OPERATING OFFICER
Credential:
Phone: 402-742-0311