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Premium Direct Care Providers Inc.
Developmental Disabilities Clinic/Center in Pueblo, Colorado
NPI 1346615085

Premium Direct Care Providers Inc. is a Developmental Disabilities Clinic/Center based in Pueblo, CO and is specialized in Developmental Disabilities. Premium Direct Care Providers Inc. practices in Pueblo, CO. The NPI Number for Premium Direct Care Providers Inc. is 1346615085 and holds a License No. (Colorado).

The current practice location address for Premium Direct Care Providers Inc. is 1612 Bonforte Blvd, Pueblo, CO and can be reached out via phone at 719-543-3600.

Location: 1612 Bonforte Blvd, Pueblo, CO, 81001-1603
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
institution
Provider Profile Details
NPI Number
1346615085
Provider Name
Premium Direct Care Providers Inc.
Credential
Provider Entity Type
Organization
Address
1612 Bonforte Blvd, Pueblo, CO, 81001-1603
Phone Number
719-543-3600
Fax Number
Provider Enumeration Date
12/07/2015
Last Update Date
03/09/2024
institution
Provider Business Practice Location Address Details
Address
1612 Bonforte Blvd
City
Pueblo
State
Colorado
Zip
81001-1603
Phone Number
719-543-3600
Fax Number
person
Provider Business Mailing Address Details
Address
1612 Bonforte Blvd
City
Pueblo
State
Colorado
Zip
81001-1603
Phone Number
719-543-3600
Fax Number
person
Provider's Taxonomy Details 1
Type
Ambulatory Health Care Facilities
Classification
Clinic/Center
Speciality
Developmental Disabilities
Taxonomy
261QD1600X
License No.
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Definition
An entity, facility, or distinct part of a facility providing comprehensive, multidiscipline diagnostic, treatment, therapy, training, and counseling services to children with congenital disorders that precipitate developmental delays and in many instances mental deficiencies (e.g., Cerebral Palsy, metabolic disorders, Sturge-Weber Syndrome, etc.).
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