Provider Demographics
NPI:1518103894
Name:WHEAT RIDGE REGIONAL CENTER
Entity Type:Organization
Organization Name:WHEAT RIDGE REGIONAL CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR WHEAT RIDGE REGIONAL CNTR
Authorized Official - Prefix:
Authorized Official - First Name:JOELLE
Authorized Official - Middle Name:
Authorized Official - Last Name:HENAO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:303-463-2657
Mailing Address - Street 1:6397 LAMAR PL
Mailing Address - Street 2:
Mailing Address - City:ARVADA
Mailing Address - State:CO
Mailing Address - Zip Code:80004
Mailing Address - Country:US
Mailing Address - Phone:303-422-4483
Mailing Address - Fax:
Practice Address - Street 1:6397 LAMAR PL
Practice Address - Street 2:
Practice Address - City:ARVADA
Practice Address - State:CO
Practice Address - Zip Code:80003-4950
Practice Address - Country:US
Practice Address - Phone:303-422-4483
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-12-17
Last Update Date:2021-07-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes315P00000XNursing & Custodial Care FacilitiesIntermediate Care Facility, Intellectual Disabilities