Healthcare Provider Details

I. General information

NPI: 1104009547
Provider Name (Legal Business Name): SALIDA SENIOR DAY CARE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/07/2007
Last Update Date: 04/11/2022
Certification Date: 04/11/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

348 G ST
SALIDA CO
81201-2021
US

IV. Provider business mailing address

PO BOX 44
SALIDA CO
81201-0044
US

V. Phone/Fax

Practice location:
  • Phone: 719-539-4396
  • Fax:
Mailing address:
  • Phone: 719-539-4396
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code372600000X
TaxonomyAdult Companion
License Number
License Number State

VIII. Authorized Official

Name: MRS. YVONNE L BRADEN
Title or Position: FACILITY DIRECTOR
Credential:
Phone: 719-539-4396