Provider Demographics
NPI:1437527447
Name:WONDERMENT ENTERPRISES, INC.
Entity type:Organization
Organization Name:WONDERMENT ENTERPRISES, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:ERIC
Authorized Official - Middle Name:WAYNE
Authorized Official - Last Name:LAPP
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:720-484-4996
Mailing Address - Street 1:PO BOX 149
Mailing Address - Street 2:
Mailing Address - City:WHEAT RIDGE
Mailing Address - State:CO
Mailing Address - Zip Code:80034-0149
Mailing Address - Country:US
Mailing Address - Phone:720-484-4996
Mailing Address - Fax:
Practice Address - Street 1:6870 W 52ND AVE
Practice Address - Street 2:101
Practice Address - City:ARVADA
Practice Address - State:CO
Practice Address - Zip Code:80002-3951
Practice Address - Country:US
Practice Address - Phone:720-484-4996
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-09-08
Last Update Date:2016-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes324500000XResidential Treatment FacilitiesSubstance Abuse Rehabilitation Facility
No251S00000XAgenciesCommunity/Behavioral Health
No320800000XResidential Treatment FacilitiesCommunity Based Residential Treatment Facility, Mental Illness