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OAK STREET FACILITY
NPI 1003354465
Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities in Lamar, CO

Active since February 06, 2017
1111 S 4TH STREET, LAMAR, CO 81052(719) 336-3244(719) 336-3898 Get Directions Write a Review

NPPES record last updated: February 6, 2017. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Oak Street Facility NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

OAK STREET FACILITY (NPI 1003354465) is a healthcare organization registered as a community based residential treatment facility, intellectual and/or developmental disabilities in Lamar, Colorado and active in the NPI registry since February 2017. The organization lists Kimberly Engsberg, Executive Director, as its authorized official.

NPPES Registry Identity

NPI1003354465
Entity TypeOrganization
Primary Taxonomy320900000X
Legal Business NameSOUTHEASTERN DEVELOPMENTAL SERVICES, INC
Location Address1111 S 4TH STREETLamar, CO 81052-3804
Mailing AddressP.o. Box 328Lamar, CO 81052-3804 · (719) 336-3244 · Fax (719) 336-3898
Phone(719) 336-3244
Fax(719) 336-3898
Organization SubpartNo
Authorized OfficialKimberly EngsbergExecutive Director · (719) 336-3244
Enumeration DateFebruary 6, 2017
✔ NPI 1003354465 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyCommunity Based Residential Treatment Facility, Intellectual and/or Developmental DisabilitiesResidential Treatment Facilities
Taxonomy Code320900000X
Definition
A home-like residential facility providing habilitation, support and monitoring services to individuals diagnosed with mental retardation and/or developmental disabilities.
1111 S 4TH STREET, Lamar, CO 81052
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Other Names 1

Doing Business AsOak Street Facility

Other Identifiers 1

Medicaid44125062CO

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Southeastern Developmental Services, Inc's NPI number?

The NPI number for Southeastern Developmental Services, Inc is 1003354465. It was assigned to this organization in the NPPES registry on February 6, 2017. The provider is doing business as Oak Street Facility.

Where is Southeastern Developmental Services, Inc located?

Southeastern Developmental Services, Inc is located at 1111 S 4th Street, Lamar, CO 81052. The listed phone number is (719) 336-3244.

What is Southeastern Developmental Services, Inc's specialty?

The primary specialty registered for this NPI is Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities with taxonomy code 320900000X.

When was this NPI record last updated?

The NPPES record for Southeastern Developmental Services, Inc was last updated on February 6, 2017. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 9 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.