Provider Demographics
NPI:1144497975
Name:COMMUNITY LIVING ALTERNATIVES, INC.
Entity type:Organization
Organization Name:COMMUNITY LIVING ALTERNATIVES, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:BARBARA
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:KENYON-MOHRLANG
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:303-745-8015
Mailing Address - Street 1:14252 E EVANS AVE
Mailing Address - Street 2:
Mailing Address - City:AURORA
Mailing Address - State:CO
Mailing Address - Zip Code:80014-1432
Mailing Address - Country:US
Mailing Address - Phone:303-745-8015
Mailing Address - Fax:303-745-1126
Practice Address - Street 1:14252 E EVANS AVE
Practice Address - Street 2:
Practice Address - City:AURORA
Practice Address - State:CO
Practice Address - Zip Code:80014-1432
Practice Address - Country:US
Practice Address - Phone:303-745-8015
Practice Address - Fax:303-745-1126
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-05-12
Last Update Date:2022-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COH2019251S00000X, 103TM1800X
COT2021251C00000X
COT2019251C00000X
CO253Z00000X, 385HR2060X
320600000X
COT2002347E00000X
COT2016320600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes320600000XResidential Treatment FacilitiesResidential Treatment Facility, Intellectual and/or Developmental Disabilities
No251S00000XAgenciesCommunity/Behavioral HealthGroup - Multi-Specialty
No103TM1800XBehavioral Health & Social Service ProvidersPsychologistIntellectual & Developmental DisabilitiesGroup - Multi-Specialty
No251C00000XAgenciesDay Training, Developmentally Disabled Services
No253Z00000XAgenciesIn Home Supportive Care
No347E00000XTransportation ServicesTransportation Broker
No385HR2060XRespite Care FacilityRespite CareRespite Care, Intellectual and/or Developmental Disabilities, Child
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO09141037Medicaid