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General NPI Number Information
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NPI Number | 1740301092
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Entity Type | Organization
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Legal Business Name | EASTERN COLORADO SERVICES FOR THE DEVELOPMENTALLY DISABLED, INC
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Dates
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Enumeration Date | 04/03/2007
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Last Update Date | 03/07/2016
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Provider Practice Location Address
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Address Line | 617 S 10TH AVE
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City | STERLING
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State | CO
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Zip | 80751-3426
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Country | US
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Telephone | 970-522-7121
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Fax | 970-522-1173
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Provider Business Mailing Address
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Address Line | 617 S 10TH AVE P. O. BOX 1682
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City | STERLING
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State | CO
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Zip | 80751-3426
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Country | US
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Telephone | 970-522-7121
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Fax | 970-522-1173
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Authorized Official
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Title or Position | FINANCE DIRECTOR
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Name | TRACI SCHRADE
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Credential |
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Telephone | 970-522-7121
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251B00000X
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Taxonomy Name | Case Management Agency
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License Number |
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License Number State |
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