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Contact Information

SOUTHERN COLORADO DEVELOPMENTAL DISABILITIES SERVICES, INC
415 S INDIANA AVE
TRINIDAD, CO81082
 Phone: 719-846-4400
 Fax: 719-846-4543
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Early Intervention Provider Agency

252Y00000X
 

Case Management

251B00000X
 

Case Manager/Care Coordinator

171M00000X
 

Physical Medicine & Rehabilitation

208100000X 25 Physician/Physical Medicine and Rehabilitation
 

Rehabilitation

261QR0400X B4[14] Rehabilitation Agency
Indicates primary specialty

NPI Profile & details for SOUTHERN COLORADO DEVELOPMENTAL DISABILITIES SERVICES, INC

NPI Number 1982142188
LBN Legal business name SOUTHERN COLORADO DEVELOPMENTAL DISABILITIES SERVICES, INC
Authorized official DUANE ROY - (EXECUTIVE DIRECTOR)
Entity Organization
Organization subpart 1 No
Enumeration date 02/08/2017
Last updated 01/09/2020 - About 6 years ago
Identifiers
CO Medicaid 09140070
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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