Provider Demographics
NPI:1518176932
Name:EL PASO COUNTY DEPARTMENT OF HUMAN SERVICES
Entity Type:Organization
Organization Name:EL PASO COUNTY DEPARTMENT OF HUMAN SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ASST BUDGET & FINANCE MANAGER
Authorized Official - Prefix:MS
Authorized Official - First Name:SUSAN
Authorized Official - Middle Name:E
Authorized Official - Last Name:BELLOTTI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:719-444-5600
Mailing Address - Street 1:105 N SPRUCE ST
Mailing Address - Street 2:
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80905-1409
Mailing Address - Country:US
Mailing Address - Phone:719-444-5600
Mailing Address - Fax:719-444-5619
Practice Address - Street 1:105 N SPRUCE ST
Practice Address - Street 2:
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80905-1409
Practice Address - Country:US
Practice Address - Phone:719-444-5600
Practice Address - Fax:719-444-5619
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-22
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes347E00000XTransportation ServicesTransportation Broker
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO06200216Medicaid