Provider Demographics
NPI:1457569048
Name:NEURO DEVELOPMENTAL CENTER
Entity Type:Organization
Organization Name:NEURO DEVELOPMENTAL CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OTR
Authorized Official - Prefix:
Authorized Official - First Name:KARI
Authorized Official - Middle Name:
Authorized Official - Last Name:SHANKS HALL
Authorized Official - Suffix:
Authorized Official - Credentials:OTR
Authorized Official - Phone:303-756-0281
Mailing Address - Street 1:5290 E YALE CIR
Mailing Address - Street 2:STE 207
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80222-6918
Mailing Address - Country:US
Mailing Address - Phone:303-756-0281
Mailing Address - Fax:303-756-6059
Practice Address - Street 1:5290 E YALE CIR
Practice Address - Street 2:STE 207
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80222-6918
Practice Address - Country:US
Practice Address - Phone:303-756-0281
Practice Address - Fax:303-756-6059
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-18
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Multi-Specialty