Provider Demographics
NPI:1083153886
Name:EASTER SEALS COLORADO
Entity Type:Organization
Organization Name:EASTER SEALS COLORADO
Other - Org Name:ROCKY MOUNTAIN VILLAGE
Other - Org Type:Other Name
Authorized Official - Title/Position:PRESIDENT/CEO
Authorized Official - Prefix:
Authorized Official - First Name:ROMAN
Authorized Official - Middle Name:
Authorized Official - Last Name:KRAFCZYK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:720-270-4279
Mailing Address - Street 1:5755 W ALAMEDA AVE
Mailing Address - Street 2:
Mailing Address - City:LAKEWOOD
Mailing Address - State:CO
Mailing Address - Zip Code:80226-3530
Mailing Address - Country:US
Mailing Address - Phone:303-233-1666
Mailing Address - Fax:303-233-1028
Practice Address - Street 1:2644 ALVARADO ROAD
Practice Address - Street 2:
Practice Address - City:EMPIRE
Practice Address - State:CO
Practice Address - Zip Code:80438
Practice Address - Country:US
Practice Address - Phone:303-233-1666
Practice Address - Fax:720-278-7862
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-02-14
Last Update Date:2022-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO04X106385HR2050X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes385HR2050XRespite Care FacilityRespite CareRespite Care Camp