Healthcare Provider Details

I. General information

NPI: 1164502761
Provider Name (Legal Business Name): NORTHWEST COLORADO VISTING NURSE ASSOCIATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/17/2006
Last Update Date: 06/17/2022
Certification Date: 06/17/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

483 YAMPA AVE
CRAIG CO
81625-2019
US

IV. Provider business mailing address

940 CENTRAL PARK DRIVE SUITE 101
STEAMBOAT SPRINGS CO
80487-8853
US

V. Phone/Fax

Practice location:
  • Phone: 970-871-7629
  • Fax: 970-826-4164
Mailing address:
  • Phone: 970-879-1632
  • Fax: 970-870-1326

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code313M00000X
TaxonomyNursing Facility/Intermediate Care Facility
License Number
License Number State

VIII. Authorized Official

Name: MATT MORRILL
Title or Position: CFO
Credential:
Phone: 970-871-7635