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General NPI Number Information
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NPI Number | 1033281514
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Entity Type | Organization
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Legal Business Name | KIT CARSON COUNTY HEALTH SERVICES DISTRICT
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Dates
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Enumeration Date | 11/14/2006
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Last Update Date | 08/24/2021
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Provider Practice Location Address
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Address Line | 286 16TH STREET
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City | BURLINGTON
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State | CO
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Zip | 80807-1651
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Country | US
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Telephone | 719-346-4721
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Fax | 719-346-5647
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Provider Business Mailing Address
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Address Line | 286 16TH STREET
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City | BURLINGTON
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State | CO
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Zip | 80807-1651
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Country | US
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Telephone | 719-346-4721
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Fax | 719-346-5647
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Authorized Official
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Title or Position | CHIEF EXECUTIVE OFFICER
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Name | MS. AMBER BRAKE
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Credential | CEO
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Telephone | 719-346-4721
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 275N00000X
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Taxonomy Name | Medicare Defined Swing Bed Hospital Unit
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License Number | 0905
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License Number State | CO
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