Eagle's Nest Group Center

Primary specialty

Intellectual and/or Developmental Disabilities Residential Treatment FacilityTaxonomy code 320600000X

Legal business name

EAGLE'S NEST GROUP CENTER

Practice address

93 Ranchettes Rd
Bailey, CO 80421-2051

Phone

(303) 838-9900

Fax

(303) 838-9901

NPI assigned

May 11, 2017

Last updated

May 11, 2017By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Melanie KennedyNPI 1205361755

Title

Ceo

Phone

(303) 875-3238

Specialties & licenses 2

Addresses

Other identifiers 1

Tax ID family

Eagle's Nest Group Center2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

• Eaglesnest Group Center

  • Physical Disabilities Residential Treatment Facility
  • Bailey, CO
  • NPI 1609045350
  NPD tax ID

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Melanie Kennedy

  • Physical Disabilities Residential Treatment Facility
  • Bailey, CO
  • NPI 1205361755

  Day Training, Developmentally Disabled Services

  NPD Authorized official

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

{
    "created_epoch": "1494460800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1494460800000",
    "number": "1447786454",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "93 RANCHETTES RD",
            "city": "BAILEY",
            "state": "CO",
            "postal_code": "804212051",
            "telephone_number": "303-838-9900",
            "fax_number": "303-838-9901"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "93 RANCHETTES RD",
            "city": "BAILEY",
            "state": "CO",
            "postal_code": "804212051",
            "telephone_number": "303-838-9900",
            "fax_number": "303-838-9901"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EAGLE'S NEST GROUP CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-05-11",
        "last_updated": "2017-05-11",
        "status": "A",
        "authorized_official_last_name": "KENNEDY",
        "authorized_official_first_name": "MELANIE",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "303-875-3238"
    },
    "taxonomies": [
        {
            "code": "251C00000X",
            "taxonomy_group": "",
            "desc": "Day Training, Developmentally Disabled Services",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "320600000X",
            "taxonomy_group": "",
            "desc": "Residential Treatment Facility, Intellectual and/or Developmental Disabilities",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "84700238",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Brooke Degroat
• Diversus Health Inc (Diversus Health Services)
• Diversus Health Inc (Diversus Health Services)
• Jennifer Dailey Dougherty, ATC, CMT
• Wendy L Dutton, DAOM, L.AC.
• Eaglesnest Group Center
• Edge Medical Services
• Elevation Gain Counseling Services LLC
• Family Integration Counseling Service, Inc.
• Five Points Wellness, LLC (Bailey BioHealth)

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 11, 2017; 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.