NPI 1245938257

Individual Canvas LLC

Organisation Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility Pueblo, CO

Practice location

Address: 46 Regency Blvd APT I, Pueblo, CO 81005-1831
Phone: (719) 334-3123

Authorised official

Name: Theresa Marie Sandoval
Title: Executive Director
Phone: (719) 334-3123

Registered specialties (2)

Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility Primary

Residential Treatment Facilities Taxonomy 320900000X

Other Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities providers in Colorado →

Transportation Broker

Transportation Services Taxonomy 347E00000X

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Registry record

NPI: 1245938257
Entity type: Organization
NPI issued: 20 Feb 2023
Record last updated: 13 Mar 2023

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.