NPIMap

Organization Active NPI

Developmental Disabilities Center

Doing business as Imagine

  • Developmentally Disabled Services Day Training Agency
  • Longmont, CO
National Provider Identifier
1962522235
Registry record updated Nov 1, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Developmentally Disabled Services Day Training AgencyTaxonomy code 251C00000X
Legal business name
DEVELOPMENTAL DISABILITIES CENTER
Doing business as
Imagine
Practice address
1960 Ken Pratt Blvd Ste D
Longmont, CO 80503-6045
Phone
(303) 776-2388
NPI assigned
Mar 30, 2007
Last updated
Nov 1, 2016By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 1, 2016

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

Authorized official

Name
Mr. John B Nevins
Title
Cfo
Phone
(303) 665-7789

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Developmentally Disabled Services Day Training Agency 251C00000X NU Primary

Addresses

Primary practice location

1960 Ken Pratt Blvd Ste D
Longmont, CO 80503-6045

Mailing address

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

Other identifiers 1

IdentifierTypeStateIssuer
09143249MedicaidCO

Other names 1

  • IMAGINE Doing business as

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

Locations

1960 Ken Pratt Blvd
Ste D
Longmont, CO 80501
Phone (303) 776-2388

NPI Registry JSON

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

{
    "created_epoch": "1175212800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1477958400000",
    "number": "1962522235",
    "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": "1960 KEN PRATT BLVD STE D",
            "city": "LONGMONT",
            "state": "CO",
            "postal_code": "805036045",
            "telephone_number": "303-776-2388"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DEVELOPMENTAL DISABILITIES CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-30",
        "last_updated": "2016-11-01",
        "status": "A",
        "authorized_official_last_name": "NEVINS",
        "authorized_official_first_name": "JOHN",
        "authorized_official_middle_name": "B",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "303-665-7789",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "251C00000X",
            "taxonomy_group": "",
            "desc": "Day Training, Developmentally Disabled Services",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "09143249",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "IMAGINE",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Longmont, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 1, 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.