NPIMap

Organization Active NPI

Huerfano Las Animas Area Council of Governments

  • In Home Supportive Care Agency
  • Trinidad, CO
National Provider Identifier
1245801422
Registry record updated Jul 8, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
In Home Supportive Care AgencyTaxonomy code 253Z00000X
Legal business name
HUERFANO LAS ANIMAS AREA COUNCIL OF GOVERNMENTS
Practice address
300 S Bonaventure Ave
Trinidad, CO 81082-2047
Phone
(719) 845-1133
Fax
(719) 845-1130
NPI assigned
Jul 8, 2021
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2021

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

Authorized official

Name
Mr. Walter Boulden
Title
Executive Director
Phone
(719) 845-1133

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
In Home Supportive Care Agency 253Z00000X Primary

Addresses

Primary practice location

300 S Bonaventure Ave
Trinidad, CO 81082-2047

Mailing address

300 S Bonaventure Ave
Trinidad, CO 81082-2047
Phone (719) 845-1133

Other identifiers 1

IdentifierTypeStateIssuer
04138194MedicaidCO

Other names 1

  • South Central Council of Governments Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Huerfano Las Animas Area Council of Governments4 organizations share this tax ID, including this one

Other organizations with this tax ID 3

Organizations that report the same tax identification number in the National Provider Directory.

Locations

300 S Bonaventure Ave
Trinidad, CO 81082
Phone (719) 845-1133

NPI Registry JSON

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

{
    "created_epoch": "1625702400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1625702400000",
    "number": "1245801422",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "300 S BONAVENTURE AVE",
            "city": "TRINIDAD",
            "state": "CO",
            "postal_code": "810822047",
            "telephone_number": "719-845-1133",
            "fax_number": "719-845-1130"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 S BONAVENTURE AVE",
            "city": "TRINIDAD",
            "state": "CO",
            "postal_code": "810822047",
            "telephone_number": "719-845-1133",
            "fax_number": "719-845-1130"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HUERFANO LAS ANIMAS AREA COUNCIL OF GOVERNMENTS",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-07-08",
        "last_updated": "2021-07-08",
        "certification_date": "2021-07-08",
        "status": "A",
        "authorized_official_last_name": "BOULDEN",
        "authorized_official_first_name": "WALTER",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "719-845-1133",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "253Z00000X",
            "taxonomy_group": "",
            "desc": "In Home Supportive Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "04138194",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "South Central Council of Governments",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Trinidad, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2021; 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.