Healthcare Provider Details

I. General information

NPI: 1881068062
Provider Name (Legal Business Name): TOC, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/25/2015
Last Update Date: 11/25/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1100 E MAIN ST STE A
MONTROSE CO
81401-4063
US

IV. Provider business mailing address

108 W 2ND ST
DELTA CO
81416-1802
US

V. Phone/Fax

Practice location:
  • Phone: 970-249-6080
  • Fax:
Mailing address:
  • Phone: 970-874-6115
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number04O628
License Number StateCO
# 2
Primary TaxonomyN
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number04H133
License Number StateCO

VIII. Authorized Official

Name: TRACY LAVON MARTINEZ
Title or Position: SEC/TREAS
Credential:
Phone: 970-874-6115