NPIMap

Organization Active NPI

El Pueblo Boys' and Girls' Ranch, Inc.

  • Emotionally Disturbed Childrens' Residential Treatment Facility
  • Pueblo, CO
National Provider Identifier
1992858344
Registry record updated Mar 4, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emotionally Disturbed Childrens' Residential Treatment FacilityTaxonomy code 322D00000X
License
45146 Issued in CO
Legal business name
EL PUEBLO BOYS' AND GIRLS' RANCH, INC.
Practice address
1 El Pueblo Ranch Way
Pueblo, CO 81006
Phone
(719) 544-7496
Fax
(719) 544-7705
NPI assigned
Jan 19, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 4, 2016

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

Authorized official

Name
Mr. Tim Nichols
Title
President and Ceo
Phone
(719) 404-1131

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emotionally Disturbed Childrens' Residential Treatment Facility 322D00000X 45146 CO Primary

Addresses

Primary practice location

1 El Pueblo Ranch Way
Pueblo, CO 81006

Mailing address

1 El Pueblo Ranch Way
Pueblo, CO 81006
Phone (719) 544-7496

Other names 1

  • El Pueblo...an Adolescent Treatment Community Doing business as

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 17

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 17

NPI Registry JSON

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

{
    "created_epoch": "1169164800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1457049600000",
    "number": "1992858344",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 EL PUEBLO RANCH WAY",
            "city": "PUEBLO",
            "state": "CO",
            "postal_code": "81006",
            "telephone_number": "719-544-7496",
            "fax_number": "719-544-7705"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 EL PUEBLO RANCH WAY",
            "city": "PUEBLO",
            "state": "CO",
            "postal_code": "81006",
            "telephone_number": "719-544-7496",
            "fax_number": "719-544-7705"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EL PUEBLO BOYS' AND GIRLS' RANCH, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-19",
        "last_updated": "2016-03-04",
        "status": "A",
        "authorized_official_last_name": "NICHOLS",
        "authorized_official_first_name": "TIM",
        "authorized_official_title_or_position": "PRESIDENT AND CEO",
        "authorized_official_telephone_number": "719-404-1131",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "322D00000X",
            "taxonomy_group": "",
            "desc": "Residential Treatment Facility, Emotionally Disturbed Children",
            "state": "CO",
            "license": "45146",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "El Pueblo...an Adolescent Treatment Community",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Pueblo, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 4, 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.