Sparks Residential and Support Services, INC

NPI #1053850297 in Pueblo, Colorado

Provider Information

NPI Number: 1053850297
Entity Type: Organization
Organization Name: Sparks Residential and Support Services, INC
Primary Specialty: Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities
Enumeration Date: Feb 21, 2017
Last Updated: Feb 17, 2022

Practice Location

Address: 507 W ABRIENDO AVE
City: Pueblo
State: Colorado
ZIP Code: 81004-1556
Phone: (719) 569-7962

Authorized Official

Name: PHYLLIS J. SPARKS
Title: PRESIDENT
Phone: (719) 583-0710

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities	320900000X	Primary

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