Provider Demographics
NPI:1568811933
Name:F.R.I.E.N.D.S. OF BROOMFIELD, INC
Entity Type:Organization
Organization Name:F.R.I.E.N.D.S. OF BROOMFIELD, INC
Other - Org Name:FRIENDS UNLIMITED
Other - Org Type:Doing Business As
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:GINA
Authorized Official - Middle Name:K
Authorized Official - Last Name:COUFAL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:303-404-0123
Mailing Address - Street 1:11851 SAULSBURY ST
Mailing Address - Street 2:
Mailing Address - City:BROOMFIELD
Mailing Address - State:CO
Mailing Address - Zip Code:80020-2808
Mailing Address - Country:US
Mailing Address - Phone:303-404-0123
Mailing Address - Fax:
Practice Address - Street 1:11851 SAULSBURY ST
Practice Address - Street 2:
Practice Address - City:BROOMFIELD
Practice Address - State:CO
Practice Address - Zip Code:80020-2808
Practice Address - Country:US
Practice Address - Phone:303-404-0123
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-06-07
Last Update Date:2017-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes251C00000XAgenciesDay Training, Developmentally Disabled ServicesGroup - Single Specialty
No376J00000XNursing Service Related ProvidersHomemakerGroup - Single Specialty
No385H00000XRespite Care FacilityRespite Care