Chestor House, Inc.

Key facts

NPI

1043403256

Entity type

Organization (NPI type 2)

Primary specialty

Intellectual and/or Developmental Disabilities Residential Treatment Facility 320600000X

Legal business name

CHESTOR HOUSE, INC.

Practice address

1831 Boston Ave
Suite 100
Longmont, CO 80501-8021

Phone

(303) 926-8840

NPI assigned

Aug 21, 2007

Organization subpart

No

Authorized official

Name

Debbie Spencer

Title

Executive Director

Phone

(303) 926-8840

National Provider Directory

Locations

Specialties & licenses

Addresses

Other identifiers

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Aug 21, 2007.

{
    "created_epoch": "1187654400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1187654400000",
    "number": "1043403256",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1831 BOSTON AVE",
            "address_2": "SUITE 100",
            "city": "LONGMONT",
            "state": "CO",
            "postal_code": "805018021",
            "telephone_number": "303-926-8840"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1831 BOSTON AVE",
            "address_2": "SUITE 100",
            "city": "LONGMONT",
            "state": "CO",
            "postal_code": "805018021",
            "telephone_number": "303-926-8840"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHESTOR HOUSE, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-08-21",
        "last_updated": "2007-08-21",
        "status": "A",
        "authorized_official_last_name": "SPENCER",
        "authorized_official_first_name": "DEBBIE",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "303-926-8840"
    },
    "taxonomies": [
        {
            "code": "320600000X",
            "taxonomy_group": "",
            "desc": "Residential Treatment Facility, Intellectual and/or Developmental Disabilities",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "09141177",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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