Healthcare Provider Details

I. General information

NPI: 1558485748
Provider Name (Legal Business Name): PARK COUNTY DEPT OF HUMAN SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/16/2007
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

824 CASPELLO AVE
FAIRPLAY CO
80440
US

IV. Provider business mailing address

PO BOX 968
FAIRPLAY CO
80440-0968
US

V. Phone/Fax

Practice location:
  • Phone: 719-836-4140
  • Fax: 719-836-0508
Mailing address:
  • Phone: 719-836-4140
  • Fax: 719-836-0508

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code343900000X
TaxonomyNon-emergency Medical Transport (VAN)
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code347C00000X
TaxonomyPrivate Vehicle
License Number
License Number StateCO
# 3
Primary TaxonomyY
Taxonomy Code344600000X
TaxonomyTaxi
License Number
License Number State

VIII. Authorized Official

Name: MARY BOYDARIAH
Title or Position: DIRECTOR
Credential:
Phone: 303-816-5930