| Community Advantage, Inc. | |
|
1375 Ken Pratt Blvd Longmont CO 80501-6325 | |
| (303) 684-9833 | |
| Not Available |
| Full Name | Community Advantage, Inc. |
|---|---|
| Speciality | Day Training, Developmentally Disabled Services |
| Location | 1375 Ken Pratt Blvd, Longmont, Colorado |
| Authorized Official Name and Position | Timothy Whobrey (PROVIDER ENROLLMENT) |
| Authorized Official Contact | 5026307249 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Community Advantage, Inc. 805 N Whittington Pkwy Louisville KY 40222-7101 Ph: (800) 866-0860 | Community Advantage, Inc. 1375 Ken Pratt Blvd Longmont CO 80501-6325 Ph: (303) 684-9833 |
| NPI Number | 1396952933 |
|---|---|
| Provider Enumeration Date | 05/16/2007 |
| Last Update Date | 10/14/2020 |
| Certification Date | 10/14/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1396952933 | NPI | - | NPPES |
| 09146234 | Medicaid | CO |
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