14Th Street

LBN: Southeastern Developmental Services, Inc
14Th Street is an health care organization with primary practice located at 1607 S 14Th Street , Lamar CO 81052-3804. The organization recently has only one registered license in Residential Treatment Facilities / Community Based Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities, which is considered as the primary health care specialty. Southeastern Developmental Services, Inc can be contacted via phone (719) 336-3244, or through Engsberg, Kimberly via phone (719) 336-3244.

Contact Information

Primary practice address
1607 S 14Th Street Lamar CO 81052-3804
Fax: (719) 336-3898
Website:
Authorized official contact:
Name: Engsberg, Kimberly

Profile Details

NPI number 1730627191
LBN Legal business name Southeastern Developmental Services, Inc
DBA Doing business as 14Th Street
Authorized official Engsberg, Kimberly
Entity Organization
Organization subpart 1 No
Enumeration date Feb 6th, 2017
Last updated Feb 6th, 2017 - about 9 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1730627191 NPPES
Colorado MEDICAID 34125043

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