Individual
THERESA A JORDAN DBA TRENT'S TEAM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
3812 E PIKES PEAK AVE STE 205, COLORADO SPRINGS, CO 80909-6781
(719) 660-5663
(719) 434-9603
Mailing address
3812 E PIKES PEAK AVE STE 205, COLORADO SPRINGS, CO 80909-6781
(719) 660-5663
(719) 434-9603
Taxonomy
Speciality
Code
Description
License number
State
251C00000X
Developmentally Disabled Services Day Training Agency
—
—
253Z00000X
In Home Supportive Care Agency
Primary
—
—
343900000X
Non-emergency Medical Transport (VAN)
—
—
376J00000X
Homemaker
—
—
385HR2060X
Child Intellectual and/or Developmental Disabilities Respite Care
—
—
Other
Enumeration date
12/26/2018
Last updated
06/01/2020
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