MEDICARE: SPECIAL HEARTS FAMILY CARE CORP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	320900000X	Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
2	253Z00000X	In Home Supportive Care Agency

General Provider Information

NPI Number	:	1295691848
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SPECIAL HEARTS FAMILY CARE CORP

Provider Business Mailing Address
First Line	:	1900 E PIKES PEAK AVE STE 5
Second Line	:
City	:	COLORADO SPRINGS
State	:	CO
Zip	:	80909-5862
Country	:	US
Telephone Number	:	719-985-0467
Fax Number	:

Provider Business Practice Location Address
First Line	:	1900 E PIKES PEAK AVE STE 5
Second Line	:
City	:	COLORADO SPRINGS
State	:	CO
Zip	:	80909-5862
Country	:	US
Telephone Number	:	719-987-0467
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	KETSIA AIME
Credential	:
Telephone Number	:	719-985-0467

Provider Enumeration Date	:	12/29/2025
Last Update Date	:	01/23/2026

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