Healthcare Provider Details

I. General information

NPI: 1790057602
Provider Name (Legal Business Name): STEINER SILS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/08/2012
Last Update Date: 09/19/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

115 W BIJOU AVE
FORT MORGAN CO
80701-2142
US

IV. Provider business mailing address

PO BOX 792
BRUSH CO
80723-0792
US

V. Phone/Fax

Practice location:
  • Phone: 970-867-8767
  • Fax: 970-867-2677
Mailing address:
  • Phone: 970-867-8767
  • Fax: 970-867-2677

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251C00000X
TaxonomyDevelopmentally Disabled Services Day Training Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number52954889
License Number StateCO
# 3
Primary TaxonomyN
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code385HR2060X
TaxonomyChild Intellectual and/or Developmental Disabilities Respite Care
License Number
License Number State

VIII. Authorized Official

Name: PAMELA KAY STEINER
Title or Position: OWNER
Credential:
Phone: 970-867-8767