Healthcare Provider Details

I. General information

NPI: 1720988538
Provider Name (Legal Business Name): EAGLE VALLEY SENIOR CARE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/06/2026
Last Update Date: 11/06/2026
Certification Date: 11/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

195 FREESTONE RD
EAGLE CO
81631-5930
US

IV. Provider business mailing address

PO BOX 1653
EDWARDS CO
81632-1653
US

V. Phone/Fax

Practice location:
  • Phone: 970-989-2500
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: DAN GODEC
Title or Position: BOARD CHAIR
Credential:
Phone: 970-390-6630