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General NPI Number Information
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NPI Number | 1366656845
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Entity Type | Organization
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Legal Business Name | EASTER SEALS SOUTHERN COLORADO
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Dates
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Enumeration Date | 05/10/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 225 S ACADEMY BLVD STE 104
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City | COLORADO SPRINGS
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State | CO
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Zip | 80910-2768
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Country | US
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Telephone | 719-574-9002
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Fax | 719-574-1330
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Provider Business Mailing Address
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Address Line | 225 S ACADEMY BLVD STE 104
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City | COLORADO SPRINGS
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State | CO
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Zip | 80910-2768
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Country | US
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Telephone | 719-574-9002
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Fax | 719-574-1330
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Authorized Official
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Title or Position | PRESIDENT
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Name | MRS. KATHY SALT
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Credential |
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Telephone | 719-574-9002
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QH0100X
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Taxonomy Name | Health Service Clinic/Center
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License Number |
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License Number State |
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