Healthcare Provider Details

I. General information

NPI: 1811226905
Provider Name (Legal Business Name): CONNECTING WITH COMMUNITY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/18/2009
Last Update Date: 10/20/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

895 COLUMBINE AVE
COLORADO SPRINGS CO
80904-2782
US

IV. Provider business mailing address

895 COLUMBINE AVE
COLORADO SPRINGS CO
80904-2782
US

V. Phone/Fax

Practice location:
  • Phone: 719-634-3121
  • Fax:
Mailing address:
  • Phone: 719-634-3121
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251C00000X
TaxonomyDevelopmentally Disabled Services Day Training Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License NumberO4C449
License Number StateCO
# 3
Primary TaxonomyN
Taxonomy Code385HR2060X
TaxonomyChild Intellectual and/or Developmental Disabilities Respite Care
License NumberO4C449
License Number StateCO

VIII. Authorized Official

Name: BYLA EISENSTEIN
Title or Position: EXECUTIVE DIRECTOR
Credential:
Phone: 719-634-3121