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General NPI Number Information
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NPI Number | 1558728022
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Entity Type | Organization
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Legal Business Name | CENTREPOINT SUPPORT LIVING, LLC
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Dates
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Enumeration Date | 01/28/2016
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Last Update Date | 05/11/2022
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Provider Practice Location Address
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Address Line | 6892 S YOSEMITE CT # 1-101A
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City | CENTENNIAL
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State | CO
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Zip | 80112-1464
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Country | US
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Telephone | 303-591-2185
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Fax |
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Provider Business Mailing Address
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Address Line | 6892 S YOSEMITE CT # 1-101A
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City | CENTENNIAL
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State | CO
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Zip | 80112-1464
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Country | US
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Telephone | 303-591-2185
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Fax |
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Authorized Official
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Title or Position | PRESIDENT & CEO
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Name | MR. TERRY R. WILLIAMS
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Credential |
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Telephone | 303-591-2185
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number | 1798-00
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License Number State | CO
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Taxonomy #2
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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 | 1653433
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License Number State | CO
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