OrganizationActive
1quality Life
NPI 1699816488 · Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility · Broomfield, CO
Provider details
- NPI number
- 1699816488
- Entity type
- Organization
- Primary specialty
- Intellectual and/or Developmental Disabilities Community Based Residential Treatment FacilityResidential Treatment Facilities
- Authorized official
- Eugene Van Blaricom, Director Owner
- License
- 32066 (CO)
Practice location
11975 Reed St
Suite 1
Broomfield, CO 80020-2814
Phone: (303) 439-2122
Fax: (303) 439-2622
Mailing address
11975 Reed Street
Broomfield, CO 80020-2815
Registry dates
- Enumerated
- 2007-02-12
- Last updated
- 2008-06-13
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.