Healthcare Provider Details

I. General information

NPI: 1831010016
Provider Name (Legal Business Name): SOCO CARES DBA KEEP TRINIDAD SAFE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/23/2026
Last Update Date: 07/23/2026
Certification Date: 07/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

916 ARIZONA AVE
TRINIDAD CO
81082-2118
US

IV. Provider business mailing address

916 ARIZONA AVE
TRINIDAD CO
81082-2118
US

V. Phone/Fax

Practice location:
  • Phone: 719-846-3310
  • Fax:
Mailing address:
  • Phone: 719-846-3310
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number
License Number State

VIII. Authorized Official

Name: JEREMY MAUCIONE
Title or Position: EXECUTIVE DIRECTOR
Credential:
Phone: 719-846-3310