Provider Demographics
NPI:1639631237
Name:VAN NESS DAY PROGRAM LLC
Entity Type:Organization
Organization Name:VAN NESS DAY PROGRAM LLC
Other - Org Name:SKILLS ACADEMY DP
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DIRECTOR/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:RANDEE
Authorized Official - Middle Name:
Authorized Official - Last Name:VAN NESS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:719-651-5102
Mailing Address - Street 1:1575 GARDEN OF THE GODS RD STE 200
Mailing Address - Street 2:
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80907-3483
Mailing Address - Country:US
Mailing Address - Phone:719-651-5102
Mailing Address - Fax:
Practice Address - Street 1:1575 GARDEN OF THE GODS RD STE 200
Practice Address - Street 2:
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80907-3483
Practice Address - Country:US
Practice Address - Phone:719-651-5102
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:VAN NESS DAY PROGRAM LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2019-04-02
Last Update Date:2022-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251C00000XAgenciesDay Training, Developmentally Disabled Services
No320900000XResidential Treatment FacilitiesCommunity Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities
No347E00000XTransportation ServicesTransportation Broker
No385H00000XRespite Care FacilityRespite Care