Provider Demographics
NPI:1902345291
Name:COLORADO RISE, LLC
Entity Type:Organization
Organization Name:COLORADO RISE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:COURTNEY
Authorized Official - Middle Name:S
Authorized Official - Last Name:TODD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:303-694-8794
Mailing Address - Street 1:6699 S CHERRY WAY
Mailing Address - Street 2:
Mailing Address - City:CENTENNIAL
Mailing Address - State:CO
Mailing Address - Zip Code:80121-3206
Mailing Address - Country:US
Mailing Address - Phone:303-694-8794
Mailing Address - Fax:303-200-0217
Practice Address - Street 1:6699 S CHERRY WAY
Practice Address - Street 2:
Practice Address - City:CENTENNIAL
Practice Address - State:CO
Practice Address - Zip Code:80121-3206
Practice Address - Country:US
Practice Address - Phone:303-694-8794
Practice Address - Fax:303-200-0217
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-02-20
Last Update Date:2017-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes385HR2060XRespite Care FacilityRespite CareRespite Care, Intellectual and/or Developmental Disabilities, Child