Provider Demographics
NPI:1376910620
Name:UNLIMITED POSSIBILITIES OF COLORADO, LLC
Entity Type:Organization
Organization Name:UNLIMITED POSSIBILITIES OF COLORADO, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:RYAN
Authorized Official - Middle Name:
Authorized Official - Last Name:BRENDON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:702-467-1377
Mailing Address - Street 1:PO BOX 370724
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89137
Mailing Address - Country:US
Mailing Address - Phone:702-467-1377
Mailing Address - Fax:702-823-4781
Practice Address - Street 1:361 71ST AVE
Practice Address - Street 2:
Practice Address - City:GREELEY
Practice Address - State:CO
Practice Address - Zip Code:80634-9782
Practice Address - Country:US
Practice Address - Phone:970-352-4353
Practice Address - Fax:970-352-9314
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:UNLIMITED POSSIBILITIES, LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2015-08-21
Last Update Date:2016-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
No251C00000XAgenciesDay Training, Developmentally Disabled Services
No385HR2060XRespite Care FacilityRespite CareRespite Care, Intellectual and/or Developmental Disabilities, Child
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO96824832Medicaid