Provider Demographics
NPI:1912389339
Name:MORE MAITRI, INC.
Entity Type:Organization
Organization Name:MORE MAITRI, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:BETHANY
Authorized Official - Middle Name:LEE
Authorized Official - Last Name:FRYE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:303-482-1339
Mailing Address - Street 1:2727 W 92ND AVENUE
Mailing Address - Street 2:SUITE 100D
Mailing Address - City:FEDERAL HEIGHTS
Mailing Address - State:CO
Mailing Address - Zip Code:80260
Mailing Address - Country:US
Mailing Address - Phone:303-482-1339
Mailing Address - Fax:303-429-1032
Practice Address - Street 1:720 W 84TH AVE STE 224
Practice Address - Street 2:
Practice Address - City:THORNTON
Practice Address - State:CO
Practice Address - Zip Code:80260-4800
Practice Address - Country:US
Practice Address - Phone:303-482-1339
Practice Address - Fax:303-429-1032
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-06-22
Last Update Date:2022-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes251C00000XAgenciesDay Training, Developmentally Disabled ServicesGroup - Single Specialty
No320900000XResidential Treatment FacilitiesCommunity Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO49050737Medicaid