Organization
SOUTHERN COLORADO DEVELOPMENTAL DISABILITIES SERVICES, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. DUANE ROY (EXECUTIVE DIRECTOR)
(719) 846-4409
Entity
Organization
Contact information
Practice address
1205 CONGRESS DR, TRINIDAD, CO 81082-1283
(719) 846-4409
(719) 846-4543
Mailing address
1205 CONGRESS DR, TRINIDAD, CO 81082-1283
(719) 846-4409
(719) 846-4543
Taxonomy
Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
09140070
—
CO
05
—
09144247
—
CO
Enumeration date
02/08/2017
Last updated
03/02/2020
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