TRINIDAD STATE NURSING HOME STAR CLUB ADULT DAY SERVICES PROGRAM
NPI 1386818383
Clinic/Center - Adult Day Care in Trinidad, CO

NPI Status: Active since April 22, 2008

Contact Information

409 BENEDICTA AVE
TRINIDAD STATE NURSING HOME
TRINIDAD, CO
ZIP 81082
Phone: (719) 845-2813
Fax: (719) 845-2807

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  • Organization
  • Clinic/Center
  • Adult Day Care
  • CLIA Number: 06D0676256
  • CLIA Cert. Type: Skilled Nursing Facility/Nursing Facility
  • CLIA Exp. Date: 08-31-2026

About TRINIDAD STATE NURSING HOME STAR CLUB ADULT DAY SERVICES PROGRAM

This page provides the complete NPI Profile along with additional information for Trinidad State Nursing Home Star Club Adult Day Services Program, a provider established in Trinidad, Colorado operating as a Clinic/center, focusing in adult day care . The healthcare provider is registered in the NPI registry with number 1386818383 assigned on April 2008. The practitioner's primary taxonomy code is 261QA0600X with license number 020796 (CO). The provider is registered as an organization and their NPI record was last updated 18 years ago. The provider's is doing business as Trinidad State Nursing Home Star Club Adult Day Services Program. The authorized official of this NPI record is Mr. Lee Burkholder (Nursing Home Administrator)

NPI
1386818383
Provider Legal Name
STATE OF COLORADO
Other Organization Name
TRINIDAD STATE NURSING HOME STAR CLUB ADULT DAY SERVICES PROGRAM
Other Name Type
Doing Business As (3)
Entity Type
Organization
Location Address
409 BENEDICTA AVE TRINIDAD STATE NURSING HOME TRINIDAD, CO 81082
Location Phone
(719) 845-2813
Location Fax
(719) 845-2807
Mailing Address
409 BENEDICTA AVE TRINIDAD STATE NURSING HOME STAR CLUB TRINIDAD, CO 81082
Mailing Phone
(719) 845-2813
Mailing Fax
(719) 845-2807
Is Sole Proprietor?
No
Is Organization Subpart?
Yes
Enumeration Date
04-22-2008
Last Update Date
09-26-2008
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Specialty - Primary Taxonomy

The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.

Classification

Clinic/Center Adult Day Care

Taxonomy Code
261QA0600X
Type
Ambulatory Health Care Facilities
License No.
020796
License State
CO

Secondary Taxonomies

The provider has reported to the NPI enumerator additional taxonomy codes. Multiple taxonomy codes may represent subspecialties or other areas of specialization the provider maybe licensed to practice.

No. Taxonomy Code Type Classification /
Specialization
License No. (State)
1343900000XTransportation Services

Non-emergency Medical Transport (VAN)

020796 (CO)

Insurance Plans Accepted

According to publicly available information the provider might be accepting the following health plans from these health insurance companies:

Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.

Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.

*Please verify directly with this provider to make sure your insurance plan is currently accepted.

Authorized Official

The authorized official is the designated individual with the legal authority to make changes to the provider’s official NPI record. For organizations, the authorized official must be a general partner, chairman of the board, CEO, CFO or a direct owner holding at least a 5 percent stake in the medical organization.

Authorized Official Name

MR. LEE BURKHOLDER

Authorized Official Title
NURSING HOME ADMINISTRATOR
Authorized Official Phone
(719) 846-9291

Additional Identifiers

The NPI Enumerator encourages providers to submit additional identifiers with their NPI application although the submission of this information is optional. The additional identifier(s) section includes other numbers or codes currently or formerly used as an identifier for the provider by other public healthcare entities. The identifiers may include UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers.

Identifier Type / Code Identifier State Identifier Issuer
05654058MEDICAID (05)CO 

CLIA Information

The Clinical Laboratory Improvement Amendments (CLIA) of 1988 applies to facilities or sites that test human specimens for health assessment or to diagnose, prevent, or treat disease. The CLIA Program sets standards for clinical laboratory testing and issues certificates. The NPI / CLIA crosswalk information for this NPI number is:

CLIA Number
06D0676256
Facility Type
Skilled Nursing Facility/Nursing Facility
Certificate Effective Date
September 01, 2024
Certificate Expiration Date
August 31, 2026
Laboratory Director
CRISTI SCHMIDT
Certificate Type
Certificate of Waiver
Certificate Type Description
This CLIA certificate is issued to Trinidad State Nursing Home Star Club Adult Day Services Program to perform only waived tests. CLIA defines waived tests as simple tests with a low risk for an incorrect result. Waived tests include certain tests listed in CLIA regulations, tests cleared by the FDA for home use and tests approved by the FDA for waived status and that meet CLIA waiver criteria.

Reviews for TRINIDAD STATE NURSING HOME STAR CLUB ADULT DAY SERVICES PROGRAM

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NPI NPI Number Validation

How NPI Validation Works

The NPI validation process uses the ISO-standard Luhn algorithm, a mathematical "handshake", to ensure that a provider's 10-digit ID is authentic and free of common typing errors.

To verify the NPI 1386818383, we treat the final digit (3) as the Check Digit—the target answer we need to reach. The process begins by taking the first nine digits and adding a constant value of 24, which accounts for the "80840" prefix required for all U.S. health identifiers. We then double every other digit starting from the right and sum the individual digits of those results together. For this specific NPI, that total comes to 67. The final step is to find the difference between that total and the next multiple of ten (70 - 67 = 3).

Digit-by-digit view

Use the first nine digits for the calculation. Starting from the right, double every other digit. The last digit is the check digit and is not part of the calculation.

Pos 1
1
Doubled → 2
Pos 2
3
Unchanged
Pos 3
8
Doubled → 16 → 1 + 6
Pos 4
6
Unchanged
Pos 5
8
Doubled → 16 → 1 + 6
Pos 6
1
Unchanged
Pos 7
8
Doubled → 16 → 1 + 6
Pos 8
3
Unchanged
Pos 9
8
Doubled → 16 → 1 + 6
Check
3
Target digit
Regular digit Doubled digit Check digit

Step 1: Double every other digit from the right

Starting with the rightmost digit of the first nine digits, double every other value. If doubling creates a two-digit number, add those digits together.

1 → 2 8 → 16 → 7 8 → 16 → 7 8 → 16 → 7 8 → 16 → 7

Step 2: Add all digits plus the NPI constant

Add the transformed values, the unchanged digits, and the constant 24.

2 + 3 + 1 + 6 + 6 + 1 + 6 + 1 + 1 + 6 + 3 + 1 + 6 + 24 = 67

Step 3: Find the amount needed to reach the next multiple of 10

The next multiple of ten after 67 is 70. The difference is the calculated check digit.

70 - 67 = 3
This NPI is valid
The calculated check digit is 3, which matches the last digit of 1386818383.

Other Providers at the Same Location


The following 20 providers are registered at the same or a nearby location.

Skilled Nursing Facility
409 BENEDICTA AVE
TRINIDAD, CO 81082
Clinic/Center
409 BENEDICTA AVE
TRINIDAD, CO 81082
Occupational Therapist (Physical Rehabilitation)
409 BENEDICTA AVE
TRINIDAD, CO 81082
Physical Therapy Assistant
409 BENEDICTA AVE
TRINIDAD, CO 81082
Legal Medicine
409 BENEDICTA AVE, SUITE A
TRINIDAD, CO 81082
Occupational Therapy Assistant
409 BENEDICTA AVE
TRINIDAD, CO 81082
Physical Therapy Assistant
409 BENEDICTA AVE
TRINIDAD, CO 81082
Skilled Nursing Facility
409 BENEDICTA AVE
TRINIDAD, CO 81082
Respite Care
409 BENEDICTA AVE
TRINIDAD, CO 81082
Physical Therapy Assistant
409 BENEDICTA AVE
TRINIDAD, CO 81082
Occupational Therapy Assistant
409 BENEDICTA AVE
TRINIDAD, CO 81082
Hospice, Inpatient
409 BENEDICTA AVE, SUITE A
TRINIDAD, CO 81082
Physical Therapist
409 BENEDICTA AVE
TRINIDAD, CO 81082
Physical Therapy Assistant
409 BENEDICTA AVE
TRINIDAD, CO 81082
Respite Care
409 BENEDICTA AVE
TRINIDAD, CO 81082
Physical Therapy Assistant
409 BENEDICTA AVE
TRINIDAD, CO 81082
Physical Therapy Assistant
409 BENEDICTA AVE
TRINIDAD, CO 81082
Skilled Nursing Facility
409 BENEDICTA AVE
TRINIDAD, CO 81082
Optometrist
409 BENEDICTA AVE
TRINIDAD, CO 81082
Internal Medicine
409 BENEDICTA AVE, SUITE A
TRINIDAD, CO 81082

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1386818383, enumerated as an "organization" on April 22, 2008.

The provider is located at 409 BENEDICTA AVE TRINIDAD STATE NURSING HOME TRINIDAD, CO 81082 and the phone number is (719) 845-2813.

Clinic/Center with taxonomy code 261QA0600X and a focus in Adult Day Care.

The provider might be accepting Accepts: Medicare and Medicaid. Please consult your insurance carrier or call the provider to verify.