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General NPI Number Information
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NPI Number | 1083084172
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Entity Type | Organization
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Legal Business Name | GOODWILL OF COLORADO
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Dates
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Enumeration Date | 10/01/2015
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Last Update Date | 07/31/2023
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Provider Practice Location Address
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Address Line | 1460 GARDEN OF THE GODS RD
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City | COLORADO SPRINGS
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State | CO
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Zip | 80907-3414
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Country | US
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Telephone | 719-635-4483
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Fax | 719-635-5713
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Provider Business Mailing Address
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Address Line | 1460 GARDEN OF THE GODS RD
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City | COLORADO SPRINGS
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State | CO
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Zip | 80907-3414
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Country | US
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Telephone | 719-635-4483
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Fax | 719-635-5713
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Authorized Official
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Title or Position | PRESIDENT AND CEO
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Name | MRS. KARLA GRAZIER
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Credential | CEO
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Telephone | 719-635-4483
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number | 04A845
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License Number State | CO
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