C-C Boarding Home

Primary specialty

Assisted Living Facility (Mental Illness)Taxonomy code 3104A0625X

License

AL-0012 Issued in CO

Legal business name

C-C BOARDING HOME

Practice address

412 S Hancock Ave
Colorado Springs, CO 80903-3700

Phone

(719) 635-7159

Fax

(719) 392-5723

NPI assigned

Jun 1, 2007

Organization subpart

No

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

Authorized official

Name

Mr. Ramon Castillo Jr.

Title

Treasurer

Phone

(719) 635-7159

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1180656000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1093917098",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "412 S HANCOCK AVE",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809033700",
            "telephone_number": "719-635-7159",
            "fax_number": "719-392-5723"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "412 S HANCOCK AVE",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809033700",
            "telephone_number": "719-635-7159",
            "fax_number": "719-392-5723"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "C-C BOARDING HOME",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-06-01",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "CASTILLO",
        "authorized_official_first_name": "RAMON",
        "authorized_official_title_or_position": "TREASURER",
        "authorized_official_telephone_number": "719-635-7159",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_name_suffix": "Jr."
    },
    "taxonomies": [
        {
            "code": "3104A0625X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility, Assisted Living, Mental Illness",
            "state": "CO",
            "license": "AL-0012",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Gemma Caalaman, PT
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• Assisted Living Facility (Mental Illness) in Colorado Springs, CO
• Providers in Colorado Springs, CO by specialty
• Assisted Living Facility (Mental Illness) in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.