Provider Demographics
NPI:1912367632
Name:CHOICE SERVICES OF COLORADO INC.
Entity Type:Organization
Organization Name:CHOICE SERVICES OF COLORADO INC.
Other - Org Name:CHOICE LIVING SERVICES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:ALLEN
Authorized Official - Last Name:SORENSEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:952-994-9572
Mailing Address - Street 1:720 ESHTON CT SE
Mailing Address - Street 2:SUITE 100
Mailing Address - City:COKATO
Mailing Address - State:MN
Mailing Address - Zip Code:55321-4375
Mailing Address - Country:US
Mailing Address - Phone:952-994-9569
Mailing Address - Fax:
Practice Address - Street 1:5255 MARSHALL ST
Practice Address - Street 2:
Practice Address - City:ARVADA
Practice Address - State:CO
Practice Address - Zip Code:80002-3924
Practice Address - Country:US
Practice Address - Phone:303-371-6700
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-02-24
Last Update Date:2017-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO32420838251C00000X
376J00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes251C00000XAgenciesDay Training, Developmentally Disabled ServicesGroup - Single Specialty
No376J00000XNursing Service Related ProvidersHomemakerGroup - Single Specialty