Provider Demographics
NPI:1477699833
Name:COLORADO CENTER FOR PEDIATRIC LEARNING AND DEVELOPMENT
Entity Type:Organization
Organization Name:COLORADO CENTER FOR PEDIATRIC LEARNING AND DEVELOPMENT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:JULIE
Authorized Official - Middle Name:
Authorized Official - Last Name:TOURIGNY
Authorized Official - Suffix:
Authorized Official - Credentials:MS, OTR
Authorized Official - Phone:303-333-4982
Mailing Address - Street 1:3700 QUEBEC ST UNIT 100-337
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80207-1638
Mailing Address - Country:US
Mailing Address - Phone:303-333-4982
Mailing Address - Fax:
Practice Address - Street 1:1958 ELM ST RM 310
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80220-1247
Practice Address - Country:US
Practice Address - Phone:303-333-4982
Practice Address - Fax:303-329-5894
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-30
Last Update Date:2020-12-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2251P0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistPediatricsGroup - Multi-Specialty
No225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGroup - Multi-Specialty
No225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatricsGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO36184349Medicaid