Healthcare Provider Details

I. General information

NPI: 1295691848
Provider Name (Legal Business Name): SPECIAL HEARTS FAMILY CARE CORP
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/29/2025
Last Update Date: 01/23/2026
Certification Date: 01/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1900 E PIKES PEAK AVE STE 5
COLORADO SPRINGS CO
80909-5862
US

IV. Provider business mailing address

1900 E PIKES PEAK AVE STE 5
COLORADO SPRINGS CO
80909-5862
US

V. Phone/Fax

Practice location:
  • Phone: 719-987-0467
  • Fax:
Mailing address:
  • Phone: 719-985-0467
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code320900000X
TaxonomyIntellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
License Number
License Number State

VIII. Authorized Official

Name: KETSIA AIME
Title or Position: PRESIDENT
Credential:
Phone: 719-985-0467