DENVER SOURCE, LLC (NPI# 1548789332) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1548789332 |
| Entity Type | Organization |
| Organization Name | DENVER SOURCE, LLC |
| Practice Address |
1525 W Parkhill Ave Littleton CO 80120-2614 |
| Practice Telephone | (720) 291-7230 |
| Mailing Telephone | 7202917230 |
| Enumeration Date | 2017-09-13 |
| Last Update Date | 2017-09-13 |
| Authorized Official Name | MR. JOHN PIERCE DICKEY (DIRECTOR/CEO) |
| Authorized Official Telephone | 7205970366 |
| Authorized Official Credential | BA, MHA |
| Is Organization Subpart | Y |
| Parent Organization Name | DENVER SOURCE, LLC |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 320600000X | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | Residential Treatment Facilities | ||
| N | 251B00000X | Case Management | Agencies | ||
| N | 320700000X | Residential Treatment Facility, Physical Disabilities | Residential Treatment Facilities | ||
| N | 251C00000X | Day Training, Developmentally Disabled Services | Agencies | ||
| N | 322D00000X | Residential Treatment Facility, Emotionally Disturbed Children | Residential Treatment Facilities | ||
| N | 347C00000X | Private Vehicle | Transportation Services | ||
| Y | 320900000X | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | Residential Treatment Facilities |
| Street Address |
1525 W PARKHILL AVE |
| City | LITTLETON |
| State | CO |
| Zip Code | 80120-2614 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1659751394 | John P Dickey | Case Management | 1525 W Parkhill Ave, Littleton, CO 80120-2614 | 2015-06-08 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1073156303 | Kelly Joy Brutsch | Counselor | 8191 Southpark Lane Suite 201, Littleton, CO 80120 | 2019-10-18 |
| 1902468309 | Infiniti Counseling, LLC | Clinic/Center | 4 W Dry Creek Circle, Littleton, CO 80120 | 2019-07-05 |
| 1437642642 | Brent Charles Mowery | Dentist | 209 W Littleton Blvd Ste B, Littleton, CO 80120 | 2018-06-12 |
| 1225525066 | Christopher Charles Miller | Counselor | 7851 S. Elati St., Suite 203, Littleton, CO 80120 | 2018-04-17 |
| 1417455890 | Cynthia Cline Mcrae | Counselor | 7921 Southpark Plaza, Grace Counseling, Suite 204, Littleton, CO 80120 | 2018-01-31 |
| 1780113175 | Janine Marie Lopez | Case Manager/Care Coordinator | 5500 S Sycamore, Littleton, CO 80120 | 2017-06-08 |
| 1952845588 | Hilary Sparrow Morris | Counselor | 991 Southpark Drive, #200, Cerescan, Littleton, CO 80120 | 2016-12-16 |
| 1760837132 | Supported Change,llc | Social Worker | 609 W Littleton Blvd Suite 201, Littleton, CO 80120 | 2016-05-04 |
| 1598123994 | Jarod Williams | Counselor | 8151 Southpark Ln Unit 250, Littleton, CO 80120 | 2016-02-01 |
| 1770948085 | Susan Jean Sylvester | Counselor | 609 West Littleton Blvd., Suite 201, Littleton, CO 80120 | 2015-12-31 |
| Find all providers in zip 80120 | ||||
| Taxonomy Code | 320900000X |
| Grouping | Residential Treatment Facilities |
| Classification | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities |
| A home-like residential facility providing habilitation, support and monitoring services to individuals diagnosed with mental retardation and/or developmental disabilities. |
| Notes: [7/1/2003: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1235760497 | Garden Neighbors, LLC | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 2773 W Long Dr, Littleton, CO 80120-5531 | 2020-01-27 |
| 1386284461 | Integrated Life Choices | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 7800 S Elati St Ste 111, Littleton, CO 80120-4400 | 2020-01-07 |
| 1063062313 | Interlace Living LLC | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 5912 S Cody St Ste 208, Littleton, CO 80123-9544 | 2019-09-18 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1982203535 | Special Care | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 2776 S Dunkirk Ct, Aurora, CO 80013-4744 | 2020-10-23 |
| 1083220750 | Liberty Residential LLC | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 923 S Telluride St, Aurora, CO 80017-3346 | 2020-09-18 |
| 1386254019 | Grace Mountain LLC | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 6030 Blue Ridge Dr Apt H, Highlands Ranch, CO 80130-3630 | 2020-08-07 |
| 1598381766 | Hand and Heart Host Homes Agency | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 391 S Simms St, Lakewood, CO 80228-2905 | 2020-06-23 |
| 1750907135 | Bianca Alish Lott | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 17827 E Mexico Dr, Aurora, CO 80017-5378 | 2020-06-22 |
| 1790300705 | Haset | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 855 S Kalispell Cir Unit 205, Aurora, CO 80017-2098 | 2020-06-15 |
| 1619599826 | Metro Hearts Host Homes Inc. | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 1192 Sandpiper Ln, Brighton, CO 80601-7391 | 2020-05-11 |
| 1588283550 | Roots, Limited Liability Co. | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 436 Purple Plum Ct, Fruita, CO 81521-6205 | 2020-04-10 |
| 1558909366 | Integrating Supports Colorado, Inc | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 801 Englewood Pkwy Apt G105, Englewood, CO 80110-2396 | 2019-12-12 |
| 1225679988 | Lov Adl's Corp | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 482 Teco Ct, Grand Junction, CO 81504-5858 | 2019-10-03 |
| Find all providers with the same taxonomy | ||||
Please comment or provide details below to improve the information on DENVER SOURCE, LLC.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.