Healthcare Provider Details
I. General information
NPI: 1912389339
Provider Name (Legal Business Name): MORE MAITRI, INC.
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 06/22/2015
Last Update Date: 02/08/2022
Certification Date: 02/08/2022
Deactivation Date:
Reactivation Date:
III. Provider practice location address
720 W 84TH AVE STE 224
THORNTON CO
80260-4800
US
IV. Provider business mailing address
2727 W 92ND AVENUE SUITE 100D
FEDERAL HEIGHTS CO
80260
US
V. Phone/Fax
- Phone: 303-482-1339
- Fax: 303-429-1032
- Phone: 303-482-1339
- Fax: 303-429-1032
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 251C00000X |
| Taxonomy | Developmentally Disabled Services Day Training Agency |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 320900000X |
| Taxonomy | Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
BETHANY
LEE
FRYE
Title or Position: EXECUTIVE DIRECTOR
Credential:
Phone: 303-482-1339