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General NPI Number Information
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NPI Number | 1487192019
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Entity Type | Organization
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Legal Business Name | INTERACTIVE LIVING
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Dates
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Enumeration Date | 02/02/2017
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Last Update Date | 02/02/2017
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Provider Practice Location Address
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Address Line | 11485 W POWERS AVE
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City | LITTLETON
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State | CO
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Zip | 80127-1909
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Country | US
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Telephone | 303-947-7551
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Fax |
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Provider Business Mailing Address
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Address Line | 11485 W POWERS AVE
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City | LITTLETON
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State | CO
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Zip | 80127-1909
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | MICHAEL WALTON
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Credential |
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Telephone | 720-231-5301
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 385H00000X
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Taxonomy Name | Respite Care
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License Number |
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License Number State | CO
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