Organization
THE OTERO CORPORATION
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JESSIE OTERO (PRESIDENT)
(970) 460-0385
Entity
Organization
Contact information
Practice address
1204 WEST ASH STREET, SUITE I, WINDSOR, CO 80550
(970) 460-0385
(970) 460-0386
Mailing address
1204 WEST ASH STREET, SUITE I, WINDSOR, CO 80550
(970) 460-0385
(970) 460-0386
Taxonomy
Speciality
Code
Description
License number
State
251C00000X
Developmentally Disabled Services Day Training Agency
—
—
311ZA0620X
Adult Care Home Facility
Primary
—
—
320600000X
Intellectual and/or Developmental Disabilities Residential Treatment Facility
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02125048
—
CO
Enumeration date
06/30/2009
Last updated
02/02/2021
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