Healthcare Provider Details

I. General information

NPI: 1518978667
Provider Name (Legal Business Name): CATHOLIC HEALTH INITIATIVES COLORADO
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/11/2006
Last Update Date: 05/23/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1008 MINNEQUA AVE
PUEBLO CO
81004-3733
US

IV. Provider business mailing address

PO BOX 910545
DENVER CO
80291-0545
US

V. Phone/Fax

Practice location:
  • Phone: 719-560-4000
  • Fax:
Mailing address:
  • Phone: 719-776-4188
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code273Y00000X
TaxonomyRehabilitation Hospital Unit
License Number328
License Number StateCO

VIII. Authorized Official

Name: ROB RYDER
Title or Position: CEO
Credential:
Phone: 719-285-2039