Provider Demographics
NPI:1255637021
Name:OFFERING ASSISTANCE TO THE SPECIALLY IMPAIRED SOCIETY
Entity type:Organization
Organization Name:OFFERING ASSISTANCE TO THE SPECIALLY IMPAIRED SOCIETY
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER/OPERATOR
Authorized Official - Prefix:
Authorized Official - First Name:JORDAN
Authorized Official - Middle Name:MORREI
Authorized Official - Last Name:EHRLICH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:970-672-7357
Mailing Address - Street 1:735 14TH ST SE APT 308
Mailing Address - Street 2:
Mailing Address - City:LOVELAND
Mailing Address - State:CO
Mailing Address - Zip Code:80537-8967
Mailing Address - Country:US
Mailing Address - Phone:970-672-7357
Mailing Address - Fax:970-685-4075
Practice Address - Street 1:735 14TH ST SE APT 308
Practice Address - Street 2:
Practice Address - City:LOVELAND
Practice Address - State:CO
Practice Address - Zip Code:80537-8967
Practice Address - Country:US
Practice Address - Phone:970-672-7357
Practice Address - Fax:970-685-4075
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-01-27
Last Update Date:2011-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care
No251C00000XAgenciesDay Training, Developmentally Disabled Services