=====================================================
General NPI Number Information
=====================================================
NPI Number | 1215004015
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | EASTER SEALS COLORADO
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 11/29/2006
-----------------------------------------------------
Last Update Date | 08/25/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 5755 W ALAMEDA AVE
-----------------------------------------------------
City | LAKEWOOD
-----------------------------------------------------
State | CO
-----------------------------------------------------
Zip | 80226
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 303-233-1666
-----------------------------------------------------
Fax | 303-233-1028
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 940 WADSWORTH BLVD STE 120
-----------------------------------------------------
City | LAKEWOOD
-----------------------------------------------------
State | CO
-----------------------------------------------------
Zip | 80214-4593
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 303-233-0166
-----------------------------------------------------
Fax | 303-233-1028
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | CEO
-----------------------------------------------------
Name | ROMAN KRAFCZYK
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 720-270-4279
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 385HR2050X
-----------------------------------------------------
Taxonomy Name | Respite Care Camp
-----------------------------------------------------
License Number | 47762
-----------------------------------------------------
License Number State | CO
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 261QA0600X
-----------------------------------------------------
Taxonomy Name | Adult Day Care Clinic/Center
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State | CO
-----------------------------------------------------