Provider Demographics
NPI:1902374077
Name:BOULDER COGNITIVE AND LINGUISTIC CENTER INC
Entity Type:Organization
Organization Name:BOULDER COGNITIVE AND LINGUISTIC CENTER INC
Other - Org Name:COLORADO BRAIN RECOVERY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:SARAH
Authorized Official - Middle Name:
Authorized Official - Last Name:BRITTAIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:303-447-0022
Mailing Address - Street 1:1700 E 17TH AVE STE 102
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80218-1668
Mailing Address - Country:US
Mailing Address - Phone:303-932-2030
Mailing Address - Fax:
Practice Address - Street 1:5723 ARAPAHOE AVE STE 1B
Practice Address - Street 2:
Practice Address - City:BOULDER
Practice Address - State:CO
Practice Address - Zip Code:80303-1381
Practice Address - Country:US
Practice Address - Phone:303-447-0022
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-11-07
Last Update Date:2019-10-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Single Specialty