COMMUNITY RESIDENTIAL & RESPITE, LLC (NPI# 1285087445) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1285087445 |
| Entity Type | Organization |
| Organization Name | COMMUNITY RESIDENTIAL & RESPITE, LLC |
| Other Organization Name | CREATE ART STUDIOS |
| Practice Address |
1640 E 4th St Pueblo CO 81001-4108 |
| Mailing Address |
221 S Union Ave Pueblo CO 81003-3490 |
| Practice Telephone | 7195452228 |
| Practice Fax Number | 7195452229 |
| Mailing Telephone | 7195466322 |
| Mailing Fax Number | 7195466154 |
| Enumeration Date | 2016-07-22 |
| Last Update Date | 2016-07-22 |
| Authorized Official Name | BARBARA J.H. YAEGER (OWNER/DIRECTOR) |
| Authorized Official Telephone | 7195466322 |
| Authorized Official Credential | LPC |
| Is Organization Subpart | Y |
| Parent Organization Name | COMMUNITY RESIDENTIAL & RESPITE, LLC |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 251C00000X | Day Training, Developmentally Disabled Services | Agencies |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CO | 90839056 | 05 |
| Other Name | Type Code |
|---|---|
| CREATE Art Studios | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1265873558 | Community Residential & Respite, LLC | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 221 S Union Ave, Pueblo, CO 81003-3490 | 2013-07-15 |
| Street Address |
1640 E 4TH ST |
| City | PUEBLO |
| State | CO |
| Zip Code | 81001-4108 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1588222863 | 1111 Bonforte Opco LLC | Respite Care | 855 Hunter Dr., Pueblo, CO 81001 | 2019-06-03 |
| 1992276026 | Andrew Benjamin Basham | Counselor | 1003 Rupple St Pueblo Co 81001, 606, Pueblo, CO 81001 | 2018-12-16 |
| 1316456981 | Amy R Leibli | Nurse Practitioner | 1080 Chinook Lane, Pueblo, CO 81001 | 2017-09-26 |
| 1457781262 | Ron Concialdi | Dentist | 2037 Jerry Murphy Rd., Pueblo, CO 81001 | 2013-11-14 |
| 1609146950 | Natasha Liette Mondragon | Registered Nurse | 1302 E. 5th, Pueblo, CO 81001 | 2012-01-04 |
| 1023303575 | Malinda Lee Davis | Registered Nurse | 1302 E 5th, Pueblo, CO 81001 | 2011-06-13 |
| 1679876429 | Michael Edward Leyba | Substance Abuse Rehabilitation Facility | 4 Montebello Rd., Pueblo, CO 81001 | 2010-12-17 |
| 1609008796 | Laura Ann Mcmahon | Nurse Practitioner | 4020 Jerry Murphy Rd/, Pueblo, CO 81001 | 2009-08-21 |
| 1730380882 | Corrine Stella Tafoya | Counselor | 44 Calhoun Rd, Pueblo, CO 81001 | 2007-05-29 |
| 1518171008 | George Henry Beck | Dentist | 1700 N Salem Ave, Suite A, Pueblo, CO 81001 | 2007-05-10 |
| Find all providers in zip 81001 | ||||
| Taxonomy Code | 251C00000X |
| Grouping | Agencies |
| Classification | Day Training, Developmentally Disabled Services |
| These agencies are authorized to provide day habilitation services to developmentally disabled individuals who live in their homes. The function of day habilitation is to assist an individual to acquire and maintain those life skills that enable the individual to cope more effectively with the demands of independent living. Also to raise the level of the individual's physical, mental, social, and vocational functioning. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1659924116 | Adrian Albert Hernandez | Day Training, Developmentally Disabled Services | 48 Drake St, Pueblo, CO 81005-1602 | 2019-07-23 |
| 1891232021 | Pueblo Community Connections Inc II | Day Training, Developmentally Disabled Services | 3913 Sandalwood Ln, Pueblo, CO 81005-2586 | 2017-01-25 |
| 1639623564 | In Harmony, LLC | Day Training, Developmentally Disabled Services | 1112 Pueblo Boulevard Way Spc B, Pueblo, CO 81005-2198 | 2016-08-09 |
| 1447622634 | Ted Hernandez Inc | Day Training, Developmentally Disabled Services | 105 Lehigh Ave, Pueblo, CO 81005-1855 | 2015-10-27 |
| 1629376603 | Destiny, Incorporated | Day Training, Developmentally Disabled Services | 3715 Thatcher Ave # B, Pueblo, CO 81005-1255 | 2011-03-01 |
| 1255654935 | B-4 Day Program and Residential Services Inc. | Day Training, Developmentally Disabled Services | 110 Santa Fe Dr, Pueblo, CO 81006-1174 | 2010-03-09 |
| 1457865495 | Karmen R Montes | Day Training, Developmentally Disabled Services | 1112 Pueblo Boulevard Way Spc B, Pueblo, CO 81005-2198 | 2017-11-29 |
| 1063586287 | Colorado Bluesky Enterprises Inc | Day Training, Developmentally Disabled Services | 115 W 2nd St, Pueblo, CO 81003-3223 | 2006-11-20 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1043818719 | Mike's Place LLC | Day Training, Developmentally Disabled Services | 325 Garfield Avenue, Carbondale, CO 81623 | 2020-10-14 |
| 1407453947 | Linda May Thomas-ware | Day Training, Developmentally Disabled Services | 8959 Colorado Blvd Apt 104, Thornton, CO 80229-4094 | 2020-10-07 |
| 1942814579 | Summit Supports LLC | Day Training, Developmentally Disabled Services | 735 Cristo Ln, Lafayette, CO 80026-1734 | 2020-09-01 |
| 1912519695 | Destiny Care | Day Training, Developmentally Disabled Services | 2172 S Trenton Way Apt 1-203, Denver, CO 80231-5380 | 2020-08-23 |
| 1083225726 | Asap- Alternative Solutions Assisting People LLC | Day Training, Developmentally Disabled Services | 21812 E Berry Ln, Centennial, CO 80015-6445 | 2020-08-16 |
| 1487264578 | Parker Personal Care Homes, Inc. | Day Training, Developmentally Disabled Services | 14001 E Iliff Ave Ste 204, Aurora, CO 80014-1425 | 2020-08-04 |
| 1013526656 | Kp Supports LLC | Day Training, Developmentally Disabled Services | 20477 Robins Dr, Denver, CO 80249-8587 | 2020-07-29 |
| 1356950679 | Bethel Agency | Day Training, Developmentally Disabled Services | 998 S Zeno Way, Aurora, CO 80017-3329 | 2020-07-23 |
| 1689292823 | Treeline Pass | Day Training, Developmentally Disabled Services | 1280 Vine St, Denver, CO 80206-2912 | 2020-07-13 |
| 1013534015 | Ithrive Support Services 'llc' | Day Training, Developmentally Disabled Services | 2800 W 103rd Ave Apt 1321, Federal Heights, CO 80260-8601 | 2020-06-25 |
| Find all providers with the same taxonomy | ||||
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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.