Edentree, LLC

Primary specialty

Developmentally Disabled Services Day Training AgencyTaxonomy code 251C00000X

Legal business name

EDENTREE, LLC

Practice address

19265 Lincoln Green LN
Monument, CO 80132-8739

Phone

(719) 761-2289

NPI assigned

Mar 30, 2022

Last updated

Mar 30, 2022By 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

Elisa Stanford

Title

Co-Owner

Phone

(719) 761-2289

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1648598400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1648598400000",
    "number": "1962142786",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19265 LINCOLN GREEN LN",
            "city": "MONUMENT",
            "state": "CO",
            "postal_code": "801328739",
            "telephone_number": "719-761-2289"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19265 LINCOLN GREEN LN",
            "city": "MONUMENT",
            "state": "CO",
            "postal_code": "801328739",
            "telephone_number": "719-761-2289"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EDENTREE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-03-30",
        "last_updated": "2022-03-30",
        "certification_date": "2022-03-30",
        "status": "A",
        "authorized_official_last_name": "STANFORD",
        "authorized_official_first_name": "ELISA",
        "authorized_official_title_or_position": "CO-OWNER",
        "authorized_official_telephone_number": "719-761-2289"
    },
    "taxonomies": [
        {
            "code": "251C00000X",
            "taxonomy_group": "",
            "desc": "Day Training, Developmentally Disabled Services",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 30, 2022; 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.