Healthcare Provider Details

I. General information

NPI: 1326047614
Provider Name (Legal Business Name): SUMMITWEST CARE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/19/2005
Last Update Date: 06/04/2021
Certification Date: 06/04/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2800 PRINTERS WAY STE 200
GRAND JUNCTION CO
81506-3944
US

IV. Provider business mailing address

2800 PRINTERS WAY STE 200
GRAND JUNCTION CO
81506-3944
US

V. Phone/Fax

Practice location:
  • Phone: 970-263-0202
  • Fax: 970-243-6855
Mailing address:
  • Phone: 970-263-0202
  • Fax: 970-243-6855

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License NumberCOLO DOESN'T LICENSE
License Number StateCO

VIII. Authorized Official

Name: CHARLEEN RAAUM
Title or Position: CEO
Credential:
Phone: 970-263-0202