Organization
SENIOR RESOURCE DEVELPMENT AGENCY, INC.
Active
Other names
Lifeline
Organization subpart
No
Provider details
NPI number
Authorized official
SARAH NICHOLAS (PROGRAM DEVELOPMENT DIRECTOR)
(719) 545-1212
Entity
Organization
Contact information
Practice address
230 N UNION AVE, PUEBLO, CO 81003-4207
(719) 545-1212
(719) 545-1803
Mailing address
230 N UNION AVE, PUEBLO, CO 81003-4207
(719) 545-1212
(719) 545-1803
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
980323
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
04138806
—
CO
Enumeration date
12/05/2006
Last updated
08/22/2020
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