Healthcare Provider Details

I. General information

NPI: 1134284136
Provider Name (Legal Business Name): EASTERN COLORADO SERVICES FOR THE DEVELOPMENTALLY DISABLED, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/27/2006
Last Update Date: 01/26/2025
Certification Date: 01/26/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

617 S 10TH AVE
STERLING CO
80751-3426
US

IV. Provider business mailing address

617 S 10TH AVE P. O. BOX 1682
STERLING CO
80751-3426
US

V. Phone/Fax

Practice location:
  • Phone: 970-522-7121
  • Fax: 970-522-1173
Mailing address:
  • Phone: 970-522-7121
  • Fax: 970-522-1173

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code320600000X
TaxonomyIntellectual and/or Developmental Disabilities Residential Treatment Facility
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code320900000X
TaxonomyIntellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code343900000X
TaxonomyNon-emergency Medical Transport (VAN)
License Number
License Number State
# 5
Primary TaxonomyY
Taxonomy Code373H00000X
TaxonomyDay Training/Habilitation Specialist
License Number
License Number State

VIII. Authorized Official

Name: ROBIN YAPP
Title or Position: ACCOUNTING CLERK
Credential:
Phone: 970-522-7121