Healthcare Provider Details

I. General information

NPI: 1205373701
Provider Name (Legal Business Name): SENIOR CARE SYSTEMS OF CO INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/23/2017
Last Update Date: 01/23/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3 DOUGLAS CT
PUEBLO CO
81001-1365
US

IV. Provider business mailing address

3 DOUGLAS CT
PUEBLO CO
81001-1365
US

V. Phone/Fax

Practice location:
  • Phone: 719-544-3999
  • Fax:
Mailing address:
  • Phone: 719-544-3999
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code261QA0600X
TaxonomyAdult Day Care Clinic/Center
License Number230636
License Number StateCO
# 2
Primary TaxonomyN
Taxonomy Code385H00000X
TaxonomyRespite Care
License Number230636
License Number StateCO
# 3
Primary TaxonomyY
Taxonomy Code310400000X
TaxonomyAssisted Living Facility
License Number230636
License Number StateCO

VIII. Authorized Official

Name: MS. PHYLLIS K SANCHEZ
Title or Position: CEO
Credential:
Phone: 719-544-3999