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General NPI Number Information
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NPI Number | 1255637021
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Entity Type | Organization
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Legal Business Name | OFFERING ASSISTANCE TO THE SPECIALLY IMPAIRED SOCIETY
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Dates
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Enumeration Date | 01/27/2011
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Last Update Date | 01/27/2011
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Provider Practice Location Address
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Address Line | 735 14TH ST SE APT 308
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City | LOVELAND
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State | CO
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Zip | 80537-8967
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Country | US
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Telephone | 970-672-7357
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Fax | 970-685-4075
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Provider Business Mailing Address
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Address Line | 735 14TH ST SE APT 308
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City | LOVELAND
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State | CO
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Zip | 80537-8967
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Country | US
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Telephone | 970-672-7357
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Fax | 970-685-4075
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Authorized Official
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Title or Position | OWNER/OPERATOR
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Name | JORDAN MORREI EHRLICH
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Credential |
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Telephone | 970-672-7357
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251C00000X
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Taxonomy Name | Developmentally Disabled Services Day Training Agency
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 253Z00000X
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Taxonomy Name | In Home Supportive Care Agency
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License Number |
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License Number State |
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