Developmental Disabilities Health Center | |
3205 N Academy Blvd Ste 120 Colorado Springs CO 80917-5147 | |
(719) 632-5700 | |
(719) 344-7840 |
Full Name | Developmental Disabilities Health Center |
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Speciality | Clinic/Center |
Location | 3205 N Academy Blvd Ste 120, Colorado Springs, Colorado |
Authorized Official Name and Position | Ryan Spillane (CHIEF FINANCIAL OFFICER) |
Authorized Official Contact | 7193447135 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Developmental Disabilities Health Center 3205 N Academy Blvd Suite 130 Colorado Springs CO 80917 Ph: (719) 632-5700 | Developmental Disabilities Health Center 3205 N Academy Blvd Ste 120 Colorado Springs CO 80917-5147 Ph: (719) 632-5700 |
NPI Number | 1679877138 |
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Provider Enumeration Date | 12/27/2010 |
Last Update Date | 03/16/2023 |
Medicare PECOS PAC ID | 4688583974 |
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Medicare Enrollment ID | O20030311000017 |
Identifier | Type | State | Issuer |
---|---|---|---|
1679877138 | NPI | - | NPPES |
32953771 | Medicaid | CO | |
05638267 | Medicaid | CO |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (Colorado) | Primary |
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