Community Residential & Respite, LLC

Primary specialty

Developmentally Disabled Services Day Training AgencyTaxonomy code 251C00000X

Legal business name

COMMUNITY RESIDENTIAL & RESPITE, LLC

Practice address

1640 E 4TH St
Pueblo, CO 81001-4108

Phone

(719) 545-2228

Fax

(719) 545-2229

NPI assigned

Jul 22, 2016

Organization subpart

Yes

Parent organization

COMMUNITY RESIDENTIAL & RESPITE, LLCAs reported in NPPES

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

Authorized official

Name

Barbara J.H. Yaeger, LPC

Title

Owner/Director

Phone

(719) 546-6322

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• CREATE Art Studios Doing business as

Tax ID family

Community Residential Respite LLC2 organizations share this tax ID, including this one

Part of

Community Residential Respite LLC

Other organizations with this tax ID 1

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

• Community Residential & Respite, LLC

  • Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
  • Pueblo, CO
  • NPI 1265873558
  NPD tax ID

Locations

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

• Community Residential & Respite, LLC

  • Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
  • Pueblo, CO
  • NPI 1265873558
  NPPES parent name

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

{
    "created_epoch": "1469145600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1469145600000",
    "number": "1285087445",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "221 S UNION AVE",
            "city": "PUEBLO",
            "state": "CO",
            "postal_code": "810033490",
            "telephone_number": "719-546-6322",
            "fax_number": "719-546-6154"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1640 E 4TH ST",
            "city": "PUEBLO",
            "state": "CO",
            "postal_code": "810014108",
            "telephone_number": "719-545-2228",
            "fax_number": "719-545-2229"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COMMUNITY RESIDENTIAL & RESPITE, LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "COMMUNITY RESIDENTIAL & RESPITE, LLC",
        "enumeration_date": "2016-07-22",
        "last_updated": "2016-07-22",
        "status": "A",
        "authorized_official_last_name": "YAEGER",
        "authorized_official_first_name": "BARBARA",
        "authorized_official_middle_name": "J.H.",
        "authorized_official_title_or_position": "OWNER/DIRECTOR",
        "authorized_official_telephone_number": "719-546-6322",
        "authorized_official_credential": "LPC"
    },
    "taxonomies": [
        {
            "code": "251C00000X",
            "taxonomy_group": "",
            "desc": "Day Training, Developmentally Disabled Services",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "90839056",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "CREATE Art Studios",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Developmentally Disabled Services Day Training Agency in Pueblo, CO
• Providers in Pueblo, CO by specialty
• Developmentally Disabled Services Day Training Agency in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 22, 2016; 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.