Organization · Type 2 NPI

Southern Colorado Developmental Disabilities Services, Inc

Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility · Walsenburg, CO

NPI number 1053859611 Active

Practice location

309 E Elder St
Walsenburg, CO 81089-1601

Call (719) 894-6454 Map

Mailing address

1205 Congress Dr
Trinidad, CO 81082-1283

Specialties and licenses

Taxonomy	Code	License
Developmentally Disabled Services Day Training Agency	251C00000X	None listed
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility Primary	320900000X	0507X0 (CO)
Bus	347B00000X	None listed

Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility: A home-like residential facility providing habilitation, support and monitoring services to individuals diagnosed with intellectual and/or developmental disabilities.

NPI record

NPI: 1053859611
Entity type: Organization (Type 2)
Issued: Feb 3, 2017
Last updated: Sep 29, 2025
Status: Active
Subpart: Yes of Southern Colorado Developmental Disabilities Services, Inc

Other names

<unavail>
Bella Vista Group Home · other name
Las Animas County Rehabilitation Center, Inc. · other name

Authorized official

Mr. Duane Roy
Executive Director
(719) 846-4409

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This page mirrors the public NPPES file. For credentialing or billing, confirm it on the official CMS NPI Registry, and check the license with the state board.

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About NPI 1053859611

Southern Colorado Developmental Disabilities Services, Inc's National Provider Identifier is 1053859611, issued on Feb 3, 2017. The primary taxonomy on file is Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility (320900000X), and the practice location is in Walsenburg, CO. The record was last updated on Sep 29, 2025.