Provider Demographics
NPI:1710280755
Name:ACTIVE BELIEF
Entity Type:Organization
Organization Name:ACTIVE BELIEF
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:JENNIFER
Authorized Official - Middle Name:J
Authorized Official - Last Name:LYLE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:720-988-3239
Mailing Address - Street 1:18375 W 59TH DR
Mailing Address - Street 2:
Mailing Address - City:GOLDEN
Mailing Address - State:CO
Mailing Address - Zip Code:80403-1064
Mailing Address - Country:US
Mailing Address - Phone:720-988-3239
Mailing Address - Fax:
Practice Address - Street 1:18375 W 59TH DR
Practice Address - Street 2:
Practice Address - City:GOLDEN
Practice Address - State:CO
Practice Address - Zip Code:80403-1064
Practice Address - Country:US
Practice Address - Phone:720-988-3239
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-12-14
Last Update Date:2010-12-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251C00000XAgenciesDay Training, Developmentally Disabled Services