Provider Demographics
NPI:1013193861
Name:RESIDENTIAL CARE SERVICES
Entity Type:Organization
Organization Name:RESIDENTIAL CARE SERVICES
Other - Org Name:RCS GROUP HOME
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MISS
Authorized Official - First Name:MICHELLE
Authorized Official - Middle Name:DEON
Authorized Official - Last Name:LEE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:720-434-1490
Mailing Address - Street 1:4328 ANDES WAY
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80249-6582
Mailing Address - Country:US
Mailing Address - Phone:720-434-1790
Mailing Address - Fax:
Practice Address - Street 1:4328 ANDES WAY
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80249-6582
Practice Address - Country:US
Practice Address - Phone:720-434-1790
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-01-10
Last Update Date:2008-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO1550166385HR2060X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes385HR2060XRespite Care FacilityRespite CareRespite Care, Intellectual and/or Developmental Disabilities, Child
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO1550166OtherGROUP HOME LICENSE