Organization Name: | EATIN THERAPEUTIC CENTER |
NPI Number: | 1174815617 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | DOROTHY MONGAN (PRESIDENT) |
Mailing Address: | 123 Elm Ave Eaton |
State: | CO US |
Postal Code: | 806153425 |
Phone Number: | 9704542224 |
Fax Number: | 9704543147 |
NPI Enumeration Date: | 05/03/2011 |
NPI Last Update Date: | 05/03/2011 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 320700000X |
License Number: | 819 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | CO |
Taxonomy Type: | Residential Treatment Facilities |
Taxonomy Classification: | Residential Treatment Facility, Physical Disabilities |
Taxonomy Specialization: | |
Taxonomy Definition: | A residential facility that provides habilitation services and other care and treatment to adults or children diagnosed with developmental disabilities and/or mental retardation and are not able to live independently. |