Healthcare Provider Details

I. General information

NPI: 1639397334
Provider Name (Legal Business Name): A BETTER LIFE EXPERIENCE INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/20/2007
Last Update Date: 10/27/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

550 THORNTON PKWY SUITE 118
THORNTON CO
80229-2166
US

IV. Provider business mailing address

550 THORNTON PKWY SUITE 118
THORNTON CO
80229-2166
US

V. Phone/Fax

Practice location:
  • Phone: 303-920-9279
  • Fax: 303-920-1018
Mailing address:
  • Phone: 303-920-9279
  • Fax: 303-920-1018

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 Code347C00000X
TaxonomyPrivate Vehicle
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code385HR2060X
TaxonomyChild Intellectual and/or Developmental Disabilities Respite Care
License Number
License Number State

VIII. Authorized Official

Name: MARTIN WILSON
Title or Position: PRESIDENT
Credential:
Phone: 303-920-9279