Provider Demographics
NPI:1417433491
Name:ANDYS HOUSE LLC
Entity Type:Organization
Organization Name:ANDYS HOUSE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINICAL DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:ELAINE
Authorized Official - Middle Name:MARIE
Authorized Official - Last Name:NEELY
Authorized Official - Suffix:
Authorized Official - Credentials:NP
Authorized Official - Phone:281-217-8610
Mailing Address - Street 1:7811 POTOMAC DR
Mailing Address - Street 2:
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80920-7072
Mailing Address - Country:US
Mailing Address - Phone:713-397-0809
Mailing Address - Fax:
Practice Address - Street 1:7811 POTOMAC DR
Practice Address - Street 2:
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80920-7072
Practice Address - Country:US
Practice Address - Phone:713-397-0809
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-07-13
Last Update Date:2018-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes385H00000XRespite Care FacilityRespite Care
No385HR2060XRespite Care FacilityRespite CareRespite Care, Intellectual and/or Developmental Disabilities, Child
No385HR2065XRespite Care FacilityRespite CareRespite Care, Physical Disabilities, Child