Healthcare Provider Details

I. General information

NPI: 1801213657
Provider Name (Legal Business Name): PEAK MEDICAL COLORADO NO. 2, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/18/2014
Last Update Date: 06/22/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2719 N UNION BLVD
COLORADO SPRINGS CO
80909-1145
US

IV. Provider business mailing address

2719 N UNION BLVD
COLORADO SPRINGS CO
80909-1145
US

V. Phone/Fax

Practice location:
  • Phone: 719-636-1676
  • Fax:
Mailing address:
  • Phone: 719-636-1676
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number020522
License Number StateCO
# 2
Primary TaxonomyN
Taxonomy Code385H00000X
TaxonomyRespite Care
License Number
License Number StateCO

VIII. Authorized Official

Name: GEORGE V. HAGER
Title or Position: CEO
Credential:
Phone: 610-444-6350