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Organization

SPARKS RESIDENTIAL AND SUPPORT SERVICES, INC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
PHYLLIS J. SPARKS (PRESIDENT)
(719) 583-0710
Entity
Organization

Contact information

Practice address
507 W ABRIENDO AVE, PUEBLO, CO 81004-1556
(719) 569-7962
Mailing address
1762 27TH LN, PUEBLO, CO 81006-9702
(719) 583-0710

Taxonomy

Speciality
Code
Description
License number
State
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
Primary

Other

Enumeration date
02/21/2017
Last updated
02/17/2022
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