Healthcare Provider Details

I. General information

NPI: 1568052363
Provider Name (Legal Business Name): CROWLEY COUNTY NURSING CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/25/2021
Last Update Date: 11/01/2022
Certification Date: 11/01/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

401 IDAHO AVE
ORDWAY CO
81063-1328
US

IV. Provider business mailing address

PO BOX 489
ORDWAY CO
81063-0489
US

V. Phone/Fax

Practice location:
  • Phone: 719-267-3561
  • Fax: 719-267-3441
Mailing address:
  • Phone: 719-267-3561
  • Fax: 719-267-3441

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code385H00000X
TaxonomyRespite Care
License Number
License Number State

VIII. Authorized Official

Name: MR. SCOTT A NELSON
Title or Position: ADMINISTRATOR
Credential:
Phone: 719-267-3561