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General NPI Number Information
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NPI Number | 1104009547
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Entity Type | Organization
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Legal Business Name | SALIDA SENIOR DAY CARE
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Dates
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Enumeration Date | 12/07/2007
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Last Update Date | 04/11/2022
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Provider Practice Location Address
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Address Line | 348 G ST
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City | SALIDA
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State | CO
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Zip | 81201-2021
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Country | US
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Telephone | 719-539-4396
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 44
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City | SALIDA
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State | CO
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Zip | 81201-0044
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Country | US
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Telephone | 719-539-4396
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Fax |
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Authorized Official
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Title or Position | FACILITY DIRECTOR
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Name | MRS. YVONNE L BRADEN
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Credential |
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Telephone | 719-539-4396
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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 |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 372600000X
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Taxonomy Name | Adult Companion
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License Number |
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License Number State |
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