Provider Demographics
NPI:1194185918
Name:COLORADO CHOICE CARE SERVICES
Entity Type:Organization
Organization Name:COLORADO CHOICE CARE SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:HORLANDE
Authorized Official - Middle Name:
Authorized Official - Last Name:YOUDE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:303-317-4244
Mailing Address - Street 1:1450 SOUTH HAVANA ST #226
Mailing Address - Street 2:
Mailing Address - City:AURORA
Mailing Address - State:CO
Mailing Address - Zip Code:80012
Mailing Address - Country:US
Mailing Address - Phone:720-620-8819
Mailing Address - Fax:720-222-0665
Practice Address - Street 1:1450 SOUTH HAVANA ST #226
Practice Address - Street 2:
Practice Address - City:AURORA
Practice Address - State:CO
Practice Address - Zip Code:80012
Practice Address - Country:US
Practice Address - Phone:720-620-8819
Practice Address - Fax:720-222-0665
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-03-07
Last Update Date:2022-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes385HR2060XRespite Care FacilityRespite CareRespite Care, Intellectual and/or Developmental Disabilities, Child
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO62782878Medicaid