Provider Demographics
NPI:1689812059
Name:CENTER FOR DISABILITIES
Entity Type:Organization
Organization Name:CENTER FOR DISABILITIES
Other - Org Name:CENTER HOME HEALTH CARE
Other - Org Type:Other Name
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:CLYDE
Authorized Official - Last Name:EDWARDS
Authorized Official - Suffix:
Authorized Official - Credentials:THM
Authorized Official - Phone:719-546-1271
Mailing Address - Street 1:901 WEST 8TH STREET
Mailing Address - Street 2:
Mailing Address - City:PUEBLO
Mailing Address - State:CO
Mailing Address - Zip Code:81003-2003
Mailing Address - Country:US
Mailing Address - Phone:719-546-1271
Mailing Address - Fax:719-546-1374
Practice Address - Street 1:901 WEST 8TH STREET
Practice Address - Street 2:
Practice Address - City:PUEBLO
Practice Address - State:CO
Practice Address - Zip Code:81003-2003
Practice Address - Country:US
Practice Address - Phone:719-546-1271
Practice Address - Fax:719-546-1374
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:CENTER FOR DISABILITIES
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2009-01-23
Last Update Date:2020-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes251E00000XAgenciesHome HealthGroup - Single Specialty
No171WH0202XOther Service ProvidersContractorHome ModificationsGroup - Single Specialty
No251B00000XAgenciesCase ManagementGroup - Single Specialty
No253Z00000XAgenciesIn Home Supportive Care