NPIMap

Envision Creative Support for People With Developmental Disabilities

Organization Active NPI Early Intervention Provider Agency · Evans, CO

NPI 1912394396 · NPPES record last updated Apr 23, 2015

Key facts

NPI
1912394396
Entity type
Organization (NPI type 2)
Primary specialty
Early Intervention Provider Agency 252Y00000X
Legal business name
ENVISION CREATIVE SUPPORT FOR PEOPLE WITH DEVELOPMENTAL DISABILITIES
Practice address
1050 37TH St
Evans, CO 80620-2115
Phone
(970) 339-5360
Fax
(970) 330-2261
NPI assigned
Apr 23, 2015
Organization subpart
No

Authorized official

Name
Mary Lu Walton
Title
Executive Director
Phone
(970) 339-5360

Corporate family (same tax ID) 5

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

National Provider Directory

Tax ID family
Envision Creative Support for People With Developmental Disabilities (6 organizations share this tax ID)

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Early Intervention Provider Agency 252Y00000X Yes

Addresses

Primary practice location

1050 37TH St
Evans, CO 80620-2115

Mailing address

PO Box 200069
Evans, CO 80620-0069
Phone (970) 339-5360

Other identifiers

IdentifierTypeStateIssuer
09139676MedicaidCO
50057367MedicaidCO
09145764MedicaidCO

Other providers in Evans, CO

All providers in Evans, CO · Early Intervention Provider Agency in Colorado

Sources for this page

Verify at the official NPI Registry.