Pueblo Diversified Industries, Inc.

Primary specialty

Developmentally Disabled Services Day Training AgencyTaxonomy code 251C00000X

Legal business name

PUEBLO DIVERSIFIED INDUSTRIES, INC.

Practice address

2828 Granada Blvd
Pueblo, CO 81005-3104

Phone

(719) 564-0000

NPI assigned

Apr 27, 2016

Organization subpart

No

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

Authorized official

Name

Bryana Burns

Title

Cfo

Phone

(719) 564-0000

Specialties & licenses 3

Addresses

Other identifiers 1

Locations

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

{
    "created_epoch": "1461715200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1461801600000",
    "number": "1457706483",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2828 GRANADA BLVD",
            "city": "PUEBLO",
            "state": "CO",
            "postal_code": "810053104",
            "telephone_number": "719-564-0000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2828 GRANADA BLVD",
            "city": "PUEBLO",
            "state": "CO",
            "postal_code": "810053104",
            "telephone_number": "719-564-0000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PUEBLO DIVERSIFIED INDUSTRIES, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-04-27",
        "last_updated": "2016-04-28",
        "status": "A",
        "authorized_official_last_name": "BURNS",
        "authorized_official_first_name": "BRYANA",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "719-564-0000"
    },
    "taxonomies": [
        {
            "code": "251C00000X",
            "taxonomy_group": "",
            "desc": "Day Training, Developmentally Disabled Services",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "253Z00000X",
            "taxonomy_group": "",
            "desc": "In Home Supportive Care",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "09142183",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Pueblo County School Dist 70
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• Pueblo Department of Public Health and Environment
• Pueblo Ear Nose & Throat Specialist
• Pueblo Endodontic Asso LLC
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• Pueblo ER Physicians LLC
• Pueblo Family Dentistry PLLC

• 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 Apr 28, 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.