Healthcare Provider Details

I. General information

NPI: 1376965715
Provider Name (Legal Business Name): RITA MARIE BAKER COTA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/18/2014
Last Update Date: 01/18/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3105 W ARKANSAS AVE
DENVER CO
80219-4004
US

IV. Provider business mailing address

1611 S KING ST
DENVER CO
80219-4522
US

V. Phone/Fax

Practice location:
  • Phone: 720-878-5938
  • Fax:
Mailing address:
  • Phone: 720-878-5938
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number1004106
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: