Vista Del Rae Group Home

LBN: Southern Colorado Developmental Disabilities Services, Inc
Vista Del Rae Group Home is an health care organization with primary practice located at 1402 Atchison Ave , Trinidad CO 81082-2282. The organization recently has 4 registered licenses in different health care specialties including Agencies / Day Training, Developmentally Disabled Services, Residential Treatment Facilities / Community Based Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities, Suppliers / Durable Medical Equipment & Medical Supplies, Transportation Services / Bus. Residential Treatment Facilities / Community Based Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities is the primary health care specialty. Southern Colorado Developmental Disabilities Services, Inc can be contacted via phone (719) 846-3391, or through Roy, Duane via phone (719) 846-4409.

Contact Information

Primary practice address
1402 Atchison Ave Trinidad CO 81082-2282
Phone: (719) 846-3391
Fax:
Website:
Map and Directions
Authorized official contact:
Name: Roy, Duane
Phone: (719) 846-4409

Health care specialties

SpecialtyCodeLicense #State
Agencies / Day Training, Developmentally Disabled Services 251C00000X
Residential Treatment Facilities / Community Based Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities 320900000X
Suppliers / Durable Medical Equipment & Medical Supplies 332B00000X
Transportation Services / Bus 347B00000X

Profile Details

NPI number 1972041192
LBN Legal business name Southern Colorado Developmental Disabilities Services, Inc
DBA Doing business as Vista Del Rae Group Home
Authorized official Roy, Duane
Entity Organization
Organization subpart 1 Yes
Enumeration date Feb 8th, 2017
Last updated Oct 23rd, 2023 - about 2 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1972041192 NPPES
Colorado MEDICAID 09140070

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