Southern Colorado Developmental Disabilities Services, INC
Early Intervention Provider Agency in Trinidad, CO. Organization (NPI-2).
NPI number1982142188
StatusActive
Last updated in NPPESJan 9, 2020
Details
- NPI
- 1982142188
- Entity type
- Organization (NPI-2)
- Legal business name
- Southern Colorado Developmental Disabilities Services, INC
- Organization subpart
- No
- Enumeration date
- Feb 8, 2017
- Certification date
- Jan 9, 2020
- Last updated
- Jan 9, 2020
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 252Y00000X | Early Intervention Provider Agency | – | – | Yes |
| 171M00000X | Case Manager/Care Coordinator | – | – | |
| 208100000X | Physical Medicine & Rehabilitation | – | – | |
| 261QR0400X | Clinic/Center, Rehabilitation | – | – | |
| 251B00000X | Case Management | – | – |
Practice location
415 S Indiana AveTrinidad, CO 81082
Phone 719-846-4400 · Fax 719-846-4543
Mailing address
1205 Congress DrTrinidad, CO 81082-1283
Phone 719-846-3391 · Fax 719-846-4543
Authorized official
Duane Roy
Executive Director
7198463391
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