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NPI Code Detail

MEDICARE: FOUNDATION FOR SUCCESSFUL LIVING

MEDICARE: FOUNDATION FOR SUCCESSFUL LIVING
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1385HR2060XChild Intellectual and/or Developmental Disabilities Respite Care04T233CO
2103K00000XBehavior Analyst
3253Z00000XIn Home Supportive Care Agency04T233CO
4376J00000XHomemaker
5251C00000XDevelopmentally Disabled Services Day Training Agency

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1902182330
Entity Type Code : Organization
Provider Name (Legal Business Name) : FOUNDATION FOR SUCCESSFUL LIVING
Provider Business Mailing Address
First Line : 1879 AUSTIN BLUFFS PKWY
Second Line :
City : COLORADO SPRINGS
State : CO
Zip : 80918-7857
Country : US
Telephone Number : 719-216-6482
Fax Number :
Provider Business Practice Location Address
First Line : 1879 AUSTIN BLUFFS PKWY
Second Line :
City : COLORADO SPRINGS
State : CO
Zip : 80918-7857
Country : US
Telephone Number : 719-216-6482
Fax Number :
Authorized Official
Title or Position : EXECUTIVE DIRECTOR
Name : PATRICIA HARRIS
Credential :
Telephone Number : 719-227-3939
Provider Enumeration Date : 10/31/2011
Last Update Date : 10/02/2018

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Directions to “FOUNDATION FOR SUCCESSFUL LIVING ” Practice Location

Language Start Address Practice Location
These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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