Healthcare Provider Details

I. General information

NPI: 1831187632
Provider Name (Legal Business Name): BAPTIST HOME ASSOCIATION OF THE ROCKY MOUNTAINS INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/06/2005
Last Update Date: 12/14/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4800 TABOR ST
DENVER CO
80033-2112
US

IV. Provider business mailing address

4800 TABOR ST
DENVER CO
80033-2112
US

V. Phone/Fax

Practice location:
  • Phone: 303-421-4161
  • Fax: 303-424-6152
Mailing address:
  • Phone: 303-421-4161
  • Fax: 303-424-6152

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number
License Number StateCO

VIII. Authorized Official

Name: DEBORAH A KOTCHER
Title or Position: DIRECTOR OF REIMBURSEMENT
Credential:
Phone: 952-253-1485