Provider Demographics
NPI:1215479290
Name:EASTERN COLORADO SERVICES FOR THE DEVELOPMENTALLY DISABLED,INC
Entity type:Organization
Organization Name:EASTERN COLORADO SERVICES FOR THE DEVELOPMENTALLY DISABLED,INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:FINANCE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:TRACI
Authorized Official - Middle Name:
Authorized Official - Last Name:SCHRADE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:970-522-7121
Mailing Address - Street 1:PO BOX 1682
Mailing Address - Street 2:
Mailing Address - City:STERLING
Mailing Address - State:CO
Mailing Address - Zip Code:80751-1682
Mailing Address - Country:US
Mailing Address - Phone:970-522-7121
Mailing Address - Fax:970-522-1173
Practice Address - Street 1:222 E CHESTNUT ST
Practice Address - Street 2:
Practice Address - City:STERLING
Practice Address - State:CO
Practice Address - Zip Code:80751-4362
Practice Address - Country:US
Practice Address - Phone:970-522-7121
Practice Address - Fax:970-522-1173
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-11-08
Last Update Date:2025-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes251C00000XAgenciesDay Training, Developmentally Disabled Services
No343900000XTransportation ServicesNon-emergency Medical Transport (VAN)Group - Multi-Specialty
No373H00000XNursing Service Related ProvidersDay Training/Habilitation SpecialistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO57125058Medicaid
CO28678Medicaid
CO57125058Medicaid
CO28678Medicaid