Provider Demographics
NPI:1982800389
Name:JAMES KELLER LLC
Entity Type:Organization
Organization Name:JAMES KELLER LLC
Other - Org Name:PEOPLE FIRST
Other - Org Type:Doing Business As
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:H
Authorized Official - Last Name:KELLER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:303-513-8176
Mailing Address - Street 1:3565 28TH ST
Mailing Address - Street 2:203
Mailing Address - City:BOULDER
Mailing Address - State:CO
Mailing Address - Zip Code:80301-1577
Mailing Address - Country:US
Mailing Address - Phone:303-513-8176
Mailing Address - Fax:303-939-8695
Practice Address - Street 1:3565 28TH ST
Practice Address - Street 2:203
Practice Address - City:BOULDER
Practice Address - State:CO
Practice Address - Zip Code:80301-1577
Practice Address - Country:US
Practice Address - Phone:303-513-8176
Practice Address - Fax:303-939-8695
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-22
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO64938824251C00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251C00000XAgenciesDay Training, Developmentally Disabled Services
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO64938824Medicaid