Healthcare Provider Details

I. General information

NPI: 1821552480
Provider Name (Legal Business Name): W, L, & J, L, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/29/2019
Last Update Date: 11/05/2021
Certification Date: 11/05/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

325 S ALMSTEAD RD
WATKINS CO
80137-8931
US

IV. Provider business mailing address

325 S ALMSTEAD RD
WATKINS CO
80137-8931
US

V. Phone/Fax

Practice location:
  • Phone: 720-484-4996
  • Fax: 720-484-4993
Mailing address:
  • Phone:
  • Fax: 720-484-4993

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code324500000X
TaxonomySubstance Abuse Rehabilitation Facility
License Number
License Number State

VIII. Authorized Official

Name: ERIC LAPP
Title or Position: CEO/FOUNDER
Credential:
Phone: 720-484-4996