Provider Demographics
NPI:1558638668
Name:BLUE PEAKS DEVELOPMENTAL SERVICES, INC
Entity Type:Organization
Organization Name:BLUE PEAKS DEVELOPMENTAL SERVICES, INC
Other - Org Name:EARLY INTERVENTION
Other - Org Type:Other Name
Authorized Official - Title/Position:FINANCE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:ANITA
Authorized Official - Middle Name:
Authorized Official - Last Name:KINSEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:719-589-5135
Mailing Address - Street 1:703 4TH STREET
Mailing Address - Street 2:
Mailing Address - City:ALAMOSA
Mailing Address - State:CO
Mailing Address - Zip Code:81101
Mailing Address - Country:US
Mailing Address - Phone:719-589-5135
Mailing Address - Fax:719-589-0680
Practice Address - Street 1:703 4TH STREET
Practice Address - Street 2:
Practice Address - City:ALAMOSA
Practice Address - State:CO
Practice Address - Zip Code:81101
Practice Address - Country:US
Practice Address - Phone:719-589-5135
Practice Address - Fax:719-589-0680
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:BLUE PEAKS DEVELOPMENTAL SERVICES, INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2011-11-18
Last Update Date:2017-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO252Y00000X
252Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes252Y00000XAgenciesEarly Intervention Provider Agency