Intermountain Community Support and Services, LLC

Primary specialty

Developmentally Disabled Services Day Training AgencyTaxonomy code 251C00000X

Legal business name

INTERMOUNTAIN COMMUNITY SUPPORT AND SERVICES, LLC

Doing business as

Icss

Practice address

12818 Newport Way
Thornton, CO 80602-6955

Phone

(303) 885-3299

Fax

(720) 242-9089

NPI assigned

Feb 16, 2012

Last updated

Feb 16, 2012By 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

Jeremy Robert Lang

Title

Co-Owner

Phone

(303) 885-3299

Specialties & licenses 1

Addresses

Other names 1

• ICSS Doing business as

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

{
    "created_epoch": "1329350400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1329350400000",
    "number": "1992078216",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12818 NEWPORT WAY",
            "city": "THORNTON",
            "state": "CO",
            "postal_code": "806026955",
            "telephone_number": "303-885-3299",
            "fax_number": "720-242-9089"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12818 NEWPORT WAY",
            "city": "THORNTON",
            "state": "CO",
            "postal_code": "806026955",
            "telephone_number": "303-885-3299",
            "fax_number": "720-242-9089"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INTERMOUNTAIN COMMUNITY SUPPORT AND SERVICES, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-02-16",
        "last_updated": "2012-02-16",
        "status": "A",
        "authorized_official_last_name": "LANG",
        "authorized_official_first_name": "JEREMY",
        "authorized_official_middle_name": "ROBERT",
        "authorized_official_title_or_position": "CO-OWNER",
        "authorized_official_telephone_number": "303-885-3299"
    },
    "taxonomies": [
        {
            "code": "251C00000X",
            "taxonomy_group": "",
            "desc": "Day Training, Developmentally Disabled Services",
            "state": "CO",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "ICSS",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Developmentally Disabled Services Day Training Agency in Thornton, CO
• Providers in Thornton, CO by specialty
• Developmentally Disabled Services Day Training Agency in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 16, 2012; 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.