NPIMap

Organization Active NPI

Integrated Life Choices (Ilc)

  • Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
  • Colorado Springs, CO
National Provider Identifier
1740864875
Registry record updated May 5, 2021
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
INTEGRATED LIFE CHOICES (ILC)
Practice address
7222 Commerce Center Dr Ste 175
Colorado Springs, CO 80919-2226
Phone
(719) 465-1538
NPI assigned
May 5, 2021
Organization subpart
Yes
Parent organization
INTEGRATED LIFE CHOICES (ILC)As reported in NPPES

NPPES NPI Registry

Updated by the provider on May 5, 2021

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

Authorized official

Name
Russ Hernandez
Title
Quality Improvement Coordinator
Phone
(303) 484-8990

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Developmentally Disabled Services Day Training Agency 251C00000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility 320900000X Primary
Non-emergency Medical Transport (VAN) 343900000X
Child Intellectual and/or Developmental Disabilities Respite Care 385HR2060X

Addresses

Primary practice location

7222 Commerce Center Dr Ste 175
Colorado Springs, CO 80919-2226

Mailing address

PO Box 80728
Lincoln, NE 68501-0728

Other identifiers 1

IdentifierTypeStateIssuer
36358851MedicaidCO

National Provider Directory

National Provider Directory
Tax ID family
Integrated Life Choices15 organizations share this tax ID, including this one
Part of
Integrated Life Choices

Other organizations with this tax ID 14

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

View all 14

Locations

7222 Commerce Center Dr
Ste 175
Colorado Springs, CO 80919
Phone (719) 465-1538

NPI Registry JSON

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

{
    "created_epoch": "1620172800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1620172800000",
    "number": "1740864875",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 80728",
            "city": "LINCOLN",
            "state": "NE",
            "postal_code": "685010728"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7222 COMMERCE CENTER DR STE 175",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809192226",
            "telephone_number": "719-465-1538"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INTEGRATED LIFE CHOICES (ILC)",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "INTEGRATED LIFE CHOICES (ILC)",
        "enumeration_date": "2021-05-05",
        "last_updated": "2021-05-05",
        "certification_date": "2021-04-21",
        "status": "A",
        "authorized_official_last_name": "HERNANDEZ",
        "authorized_official_first_name": "RUSS",
        "authorized_official_title_or_position": "QUALITY IMPROVEMENT COORDINATOR",
        "authorized_official_telephone_number": "303-484-8990"
    },
    "taxonomies": [
        {
            "code": "251C00000X",
            "taxonomy_group": "",
            "desc": "Day Training, Developmentally Disabled Services",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "320900000X",
            "taxonomy_group": "",
            "desc": "Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "343900000X",
            "taxonomy_group": "",
            "desc": "Non-emergency Medical Transport (VAN)",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "385HR2060X",
            "taxonomy_group": "",
            "desc": "Respite Care, Respite Care, Intellectual and/or Developmental Disabilities, Child",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "36358851",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Colorado Springs, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 5, 2021; 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.