NPIMap

Organization Active NPI

Developmental Disabilities Center

  • Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
  • Boulder, CO
National Provider Identifier
1437826708
Registry record updated Oct 19, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Intellectual and/or Developmental Disabilities Community Based Residential Treatment FacilityTaxonomy code 320900000X
Legal business name
DEVELOPMENTAL DISABILITIES CENTER
Practice address
4500 7TH St
Boulder, CO 80304-4394
Phone
(303) 665-7789
NPI assigned
Aug 25, 2021
Last updated
Oct 19, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 19, 2023

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

Authorized official

Name
Robin Grey
Title
Cfo
Phone
(303) 641-6342

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility 320900000X NU Primary

Addresses

Primary practice location

4500 7TH St
Boulder, CO 80304-4394

Mailing address

1400 Dixon Ave
Lafayette, CO 80026-2790
Phone (303) 665-7789

Other identifiers 1

IdentifierTypeStateIssuer
09139650MedicaidCO

National Provider Directory

National Provider Directory
Tax ID family
Developmental Disabilities Center23 organizations share this tax ID, including this one

Other organizations with this tax ID 22

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

View all 22

Locations

1400 Dixon Ave
Lafayette, CO 80026
Phone (303) 457-5719

NPI Registry JSON

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

{
    "created_epoch": "1629849600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1697673600000",
    "number": "1437826708",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1400 DIXON AVE",
            "city": "LAFAYETTE",
            "state": "CO",
            "postal_code": "800262790",
            "telephone_number": "303-665-7789"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4500 7TH ST",
            "city": "BOULDER",
            "state": "CO",
            "postal_code": "803044394",
            "telephone_number": "303-665-7789"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DEVELOPMENTAL DISABILITIES CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-08-25",
        "last_updated": "2023-10-19",
        "certification_date": "2023-10-19",
        "status": "A",
        "authorized_official_last_name": "GREY",
        "authorized_official_first_name": "ROBIN",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "303-641-6342"
    },
    "taxonomies": [
        {
            "code": "320900000X",
            "taxonomy_group": "",
            "desc": "Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "09139650",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Boulder, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 19, 2023; 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.