Healthcare Provider Details

I. General information

NPI: 1740663483
Provider Name (Legal Business Name): REAL CARE, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/30/2015
Last Update Date: 02/19/2020
Certification Date: 02/19/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10200 WEST 44TH AVE SUITE 200
WHEAT RIDGE CO
80033
US

IV. Provider business mailing address

10200 WEST 44TH AVE SUITE 200
WHEAT RIDGE CO
80033
US

V. Phone/Fax

Practice location:
  • Phone: 303-284-5818
  • Fax: 720-242-6282
Mailing address:
  • Phone: 303-284-5818
  • Fax: 720-242-6282

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code251C00000X
TaxonomyDevelopmentally Disabled Services Day Training Agency
License Number00257737
License Number StateCO
# 2
Primary TaxonomyN
Taxonomy Code251C00000X
TaxonomyDevelopmentally Disabled Services Day Training Agency
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code320600000X
TaxonomyIntellectual and/or Developmental Disabilities Residential Treatment Facility
License Number
License Number StateCO
# 4
Primary TaxonomyN
Taxonomy Code320900000X
TaxonomyIntellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
License Number10H792
License Number StateCO
# 5
Primary TaxonomyY
Taxonomy Code320900000X
TaxonomyIntellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
License Number
License Number State
# 6
Primary TaxonomyN
Taxonomy Code347C00000X
TaxonomyPrivate Vehicle
License Number
License Number State
# 7
Primary TaxonomyN
Taxonomy Code385HR2060X
TaxonomyChild Intellectual and/or Developmental Disabilities Respite Care
License Number
License Number State

VIII. Authorized Official

Name: MRS. NICOLE RENEE JEFFERSON
Title or Position: EXECUTIVE DIRECTOR
Credential:
Phone: 303-284-5818