NPIMap

Organization Active NPI

Huerfano Las Animas Area Council of Governments

  • In Home Supportive Care Agency
  • Walsenburg, CO
National Provider Identifier
1992243299
Registry record updated Jul 8, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
In Home Supportive Care AgencyTaxonomy code 253Z00000X
Legal business name
HUERFANO LAS ANIMAS AREA COUNCIL OF GOVERNMENTS
Practice address
625 N Polk Ave
Walsenburg, CO 81089-1549
Phone
(719) 738-2205
Fax
(719) 738-6898
NPI assigned
Feb 7, 2017
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2021

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

Authorized official

Name
Mr. Walter Boulden
Title
Executive Director
Phone
(719) 845-1133

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
In Home Supportive Care Agency 253Z00000X Primary
Adult Care Home Facility 311ZA0620X 10F196 CO

Addresses

Primary practice location

625 N Polk Ave
Walsenburg, CO 81089-1549

Mailing address

625 N Polk Ave
Walsenburg, CO 81089-1549
Phone (719) 738-2205

Other identifiers 2

IdentifierTypeStateIssuer
10F196OtherCOCOLORADO DEPARTMENT OF PUBLIC HEALTH AND ENVIRONMENT
19203314MedicaidCO

Other names 1

  • South Central Council of Governments Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Huerfano Las Animas Area Council of Governments4 organizations share this tax ID, including this one

Other organizations with this tax ID 3

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

Locations

625 N Polk Ave
Walsenburg, CO 81089
Phone (719) 738-2205

NPI Registry JSON

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

{
    "created_epoch": "1486425600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1625702400000",
    "number": "1992243299",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "625 N POLK AVE",
            "city": "WALSENBURG",
            "state": "CO",
            "postal_code": "810891549",
            "telephone_number": "719-738-2205",
            "fax_number": "719-738-6898"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "625 N POLK AVE",
            "city": "WALSENBURG",
            "state": "CO",
            "postal_code": "810891549",
            "telephone_number": "719-738-2205",
            "fax_number": "719-738-6898"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HUERFANO LAS ANIMAS AREA COUNCIL OF GOVERNMENTS",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-02-07",
        "last_updated": "2021-07-08",
        "certification_date": "2021-07-08",
        "status": "A",
        "authorized_official_last_name": "BOULDEN",
        "authorized_official_first_name": "WALTER",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "719-845-1133",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "253Z00000X",
            "taxonomy_group": "",
            "desc": "In Home Supportive Care",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "311ZA0620X",
            "taxonomy_group": "",
            "desc": "Custodial Care Facility, Adult Care Home",
            "state": "CO",
            "license": "10F196",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "COLORADO DEPARTMENT OF PUBLIC HEALTH AND ENVIRONMENT",
            "identifier": "10F196",
            "state": "CO"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "19203314",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "South Central Council of Governments",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "South Central Council of Governments",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Walsenburg, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 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.