Healthcare Provider Details

I. General information

NPI: 1427493824
Provider Name (Legal Business Name): LAKE COUNTY GOVERNMENT
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/30/2013
Last Update Date: 12/02/2025
Certification Date: 12/02/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

735 US HIGHWAY 24
LEADVILLE CO
80461-3978
US

IV. Provider business mailing address

PO BOX 626
LEADVILLE CO
80461-0626
US

V. Phone/Fax

Practice location:
  • Phone: 719-486-2413
  • Fax: 719-486-4168
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251K00000X
TaxonomyPublic Health or Welfare Agency
License NumberRN.1618656
License Number StateCO

VIII. Authorized Official

Name: JULIE GONZALES
Title or Position: FINANCE AND GRANTS MANAGER
Credential:
Phone: 719-486-2413