Provider Demographics
NPI:1457170532
Name:CAREGIVERS OF THE ROCKIES LLC
Entity type:Organization
Organization Name:CAREGIVERS OF THE ROCKIES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:BOIMAH
Authorized Official - Middle Name:O
Authorized Official - Last Name:KOBBAH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:720-951-2038
Mailing Address - Street 1:570 SIMMENTAL LOOP
Mailing Address - Street 2:
Mailing Address - City:CASTLE ROCK
Mailing Address - State:CO
Mailing Address - Zip Code:80104-9846
Mailing Address - Country:US
Mailing Address - Phone:720-951-2038
Mailing Address - Fax:
Practice Address - Street 1:3002 ABILENE ST
Practice Address - Street 2:
Practice Address - City:AURORA
Practice Address - State:CO
Practice Address - Zip Code:80011-2202
Practice Address - Country:US
Practice Address - Phone:720-951-2038
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-10-07
Last Update Date:2024-10-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes320900000XResidential Treatment FacilitiesCommunity Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities