NPIMap

Organization Active NPI

Developmental Disabilities Center

Doing business as Imagine

  • Adult Mental Health Clinic/Center
  • Lafayette, CO
National Provider Identifier
1508086794
Registry record updated Mar 7, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Mental Health Clinic/CenterTaxonomy code 261QM0850X
Legal business name
DEVELOPMENTAL DISABILITIES CENTER
Doing business as
Imagine
Practice address
1400 Dixon Ave
Lafayette, CO 80026-2790
Phone
(303) 665-7789
Fax
(303) 665-2648
NPI assigned
Apr 27, 2007
Last updated
Mar 7, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 7, 2024

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 4

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior AnalystGroup: 193200000X MULTI-SPECIALTY GROUP 103K00000X
Developmentally Disabled Services Day Training Agency 251C00000X
Early Intervention Provider Agency 252Y00000X
Adult Mental Health Clinic/Center 261QM0850X Primary

Addresses

Primary practice location

1400 Dixon Ave
Lafayette, CO 80026-2790

Mailing address

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

Other identifiers 1

IdentifierTypeStateIssuer
30870216MedicaidCO

Other names 1

  • IMAGINE Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CO

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20070125000573 CO Part B Supplier - Clinic/Group Practice 5597766089 Receives reassigned benefits from 5 practitioners
Practice locations: Lafayette, CO

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

Practitioners & affiliated clinicians

Practitioners 6

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.

NPI Registry JSON

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

{
    "created_epoch": "1177632000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1709769600000",
    "number": "1508086794",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1400 DIXON ST",
            "city": "LAFAYETTE",
            "state": "CO",
            "postal_code": "800262790",
            "telephone_number": "303-665-7789",
            "fax_number": "303-665-2648"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1400 DIXON AVE",
            "city": "LAFAYETTE",
            "state": "CO",
            "postal_code": "800262790",
            "telephone_number": "303-665-7789",
            "fax_number": "303-665-2648"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DEVELOPMENTAL DISABILITIES CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-27",
        "last_updated": "2024-03-07",
        "certification_date": "2024-03-05",
        "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": "103K00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Behavior Analyst",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "251C00000X",
            "taxonomy_group": "",
            "desc": "Day Training, Developmentally Disabled Services",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "252Y00000X",
            "taxonomy_group": "",
            "desc": "Early Intervention Provider Agency",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QM0850X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adult Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "30870216",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "IMAGINE",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "IMAGINE",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Lafayette, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.