Provider Demographics
NPI:1689948283
Name:RAMAH OUTDOOR ADVENTURE
Entity Type:Organization
Organization Name:RAMAH OUTDOOR ADVENTURE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BUSINESS MANAGER
Authorized Official - Prefix:MR
Authorized Official - First Name:DOUGLAS
Authorized Official - Middle Name:S
Authorized Official - Last Name:WOLF
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:303-261-8214
Mailing Address - Street 1:300 S DAHLIA ST
Mailing Address - Street 2:SUITE 205
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80246-8118
Mailing Address - Country:US
Mailing Address - Phone:303-261-8214
Mailing Address - Fax:303-261-8210
Practice Address - Street 1:26601 STONEY PASS RD
Practice Address - Street 2:
Practice Address - City:SEDALIA
Practice Address - State:CO
Practice Address - Zip Code:80135-9001
Practice Address - Country:US
Practice Address - Phone:303-261-8214
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-02-28
Last Update Date:2012-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO1590409385HR2050X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes385HR2050XRespite Care FacilityRespite CareRespite Care Camp