SOUTHERN COLORADO DEVELOPMENTAL DISABILITIES SERVICES, INC (NPI# 1053859611) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1053859611 |
Entity Type | Organization |
Organization Name | SOUTHERN COLORADO DEVELOPMENTAL DISABILITIES SERVICES, INC |
Practice Address |
309 E Elder St Walsenburg CO 81089-1601 |
Mailing Address |
1205 Congress Dr Trinidad CO 81082-1283 |
Practice Telephone | 7198946454 |
Mailing Telephone | 7198463391 |
Mailing Fax Number | 7198464543 |
Enumeration Date | 2017-02-03 |
Last Update Date | 2020-01-21 |
Authorized Official Name | MR. DUANE ROY (EXECUTIVE DIRECTOR) |
Authorized Official Telephone | 7198464409 |
Is Organization Subpart | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 320900000X | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 0507X0 | CO | Residential Treatment Facilities |
State | Issuer | Identifier | Type Code |
---|---|---|---|
CO | 09144247 | 05 | |
CO | 09140070 | 05 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1770021990 | Southern Colorado Developmental Disabilities Services, Inc | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 717 Adams, Trinidad, CO 81082-3613 | 2017-02-08 |
1598203713 | Southern Colorado Developmental Disabilities Services, Inc | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 305 Madison St, Trinidad, CO 81082-3736 | 2017-02-08 |
1972041192 | Southern Colorado Developmental Disabilities Services, Inc | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 1402 Atchison Ave, Trinidad, CO 81082-2282 | 2017-02-08 |
1508996711 | Southern Colorado Developmental Disabilities Services, Inc | Case Management | 1205 Congress Dr, Trinidad, CO 81082-1283 | 2007-03-06 |
1427596642 | Southern Colorado Developmental Disabilities Services, Inc | Case Management | 1205 Congress Dr, Trinidad, CO 81082-1283 | 2017-02-08 |
1982142188 | Southern Colorado Developmental Disabilities Services, Inc | Case Manager/Care Coordinator | 415 S Indiana Ave, Trinidad, CO 81082 | 2017-02-08 |
1437697653 | Southern Colorado Developmental Disabilities Services, Inc | Case Manager/Care Coordinator | 1205 Congress Dr, Trinidad, CO 81082-1283 | 2017-02-08 |
Street Address |
309 E ELDER ST |
City | WALSENBURG |
State | CO |
Zip Code | 81089-1601 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1336684471 | John Edward Hill | Counselor | 615 Russell St., Walsenburg, CO 81089 | 2016-12-28 |
1891997672 | Sandra Dee Majors | Counselor | 926 Russell Street, Walsenburg, CO 81089 | 2007-06-04 |
1306006143 | Olixn Lee Adams | Family Medicine | 23400 Us Highway 160, Walsenburg, CO 81089 | 2008-06-16 |
1265611354 | Diane M Ernewein | Physical Therapist | 125 E 5th St, Walsenburg, CO 81089 | 2007-10-25 |
1306905203 | Deej Health Corp | Pharmacy | 520 Main St, Walsenburg, CO 81089 | 2006-12-06 |
1710905997 | Ginger E. Dunnam-smith | Emergency Medicine | 23500 Us Highway 160, Walsenburg, CO 81089 | 2006-07-17 |
1407862386 | Kathy Ann Loeffler | Nurse Practitioner | 129 Kansas Ave, Walsenburg, CO 81089-1818 | 2006-07-31 |
1528665593 | Achieve Whole Recovery, PC | Specialist | 129 Kansas Ave, Walsenburg, CO 81089-1818 | 2020-10-02 |
1710274394 | Regina Jo Griego | Nurse Practitioner | 129 Kansas Ave, Walsenburg, CO 81089-1818 | 2011-07-05 |
1346403375 | Huerfano County Hospital District | Clinic/Center | 129 Kansas Ave, Walsenburg, CO 81089-1818 | 2008-07-09 |
Find all providers in zip 81089 |
Taxonomy Code | 320900000X |
Grouping | Residential Treatment Facilities |
Classification | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities |
A home-like residential facility providing habilitation, support and monitoring services to individuals diagnosed with mental retardation and/or developmental disabilities. |
Notes: [7/1/2003: new] |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1982203535 | Special Care | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 2776 S Dunkirk Ct, Aurora, CO 80013-4744 | 2020-10-23 |
1083220750 | Liberty Residential LLC | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 923 S Telluride St, Aurora, CO 80017-3346 | 2020-09-18 |
1386254019 | Grace Mountain LLC | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 6030 Blue Ridge Dr Apt H, Highlands Ranch, CO 80130-3630 | 2020-08-07 |
1598381766 | Hand and Heart Host Homes Agency | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 391 S Simms St, Lakewood, CO 80228-2905 | 2020-06-23 |
1750907135 | Bianca Alish Lott | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 17827 E Mexico Dr, Aurora, CO 80017-5378 | 2020-06-22 |
1790300705 | Haset | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 855 S Kalispell Cir Unit 205, Aurora, CO 80017-2098 | 2020-06-15 |
1619599826 | Metro Hearts Host Homes Inc. | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 1192 Sandpiper Ln, Brighton, CO 80601-7391 | 2020-05-11 |
1588283550 | Roots, Limited Liability Co. | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 436 Purple Plum Ct, Fruita, CO 81521-6205 | 2020-04-10 |
1235760497 | Garden Neighbors, LLC | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 2773 W Long Dr, Littleton, CO 80120-5531 | 2020-01-27 |
1386284461 | Integrated Life Choices | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 7800 S Elati St Ste 111, Littleton, CO 80120-4400 | 2020-01-07 |
Find all providers with the same taxonomy |
City | WALSENBURG |
Zip Code | 81089 |
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Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.