Sparks Residential and Support Services, Inc

Primary specialty

Intellectual and/or Developmental Disabilities Community Based Residential Treatment FacilityTaxonomy code 320900000X

Legal business name

SPARKS RESIDENTIAL AND SUPPORT SERVICES, INC

Practice address

507 W Abriendo Ave
Pueblo, CO 81004-1556

Phone

(719) 569-7962

NPI assigned

Feb 21, 2017

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Phyllis J. Sparks

Title

President

Phone

(719) 583-0710

Specialties & licenses 1

Addresses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1487635200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1645056000000",
    "number": "1053850297",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1762 27TH LN",
            "city": "PUEBLO",
            "state": "CO",
            "postal_code": "810069702",
            "telephone_number": "719-583-0710"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "507 W ABRIENDO AVE",
            "city": "PUEBLO",
            "state": "CO",
            "postal_code": "810041556",
            "telephone_number": "719-569-7962"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SPARKS RESIDENTIAL AND SUPPORT SERVICES, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-02-21",
        "last_updated": "2022-02-17",
        "certification_date": "2022-02-17",
        "status": "A",
        "authorized_official_last_name": "SPARKS",
        "authorized_official_first_name": "PHYLLIS",
        "authorized_official_middle_name": "J.",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "719-583-0710"
    },
    "taxonomies": [
        {
            "code": "320900000X",
            "taxonomy_group": "",
            "desc": "Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Lynda A Spann, PH.D.
• Sparks of Light Psychotherapy, PLLC
• Melissa R. Sparks, PTA
• Penny Sue Spearing, MA, LPC
• Specialized Inpatient Medical Services, LLC
• Spectrum of Light Family Services, LLC
• Spectrum of Light Home Care, LLC

• Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility in Pueblo, CO
• Providers in Pueblo, CO by specialty
• Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 17, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.