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General NPI Number Information
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NPI Number | 1285209346
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Entity Type | Organization
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Legal Business Name | ELDER CARE INC. OF COLORADO SPRINGS
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Dates
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Enumeration Date | 05/21/2021
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Last Update Date | 09/09/2021
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Provider Practice Location Address
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Address Line | 225 W BROOKSIDE ST
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City | COLORADO SPRINGS
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State | CO
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Zip | 80905-2105
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Country | US
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Telephone | 719-632-6511
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Fax | 719-632-0726
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Provider Business Mailing Address
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Address Line | 225 W BROOKSIDE ST
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City | COLORADO SPRINGS
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State | CO
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Zip | 80905-2105
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Country | US
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Telephone | 719-632-6511
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Fax | 719-632-0726
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | JEFFREY AARON PITUS
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Credential |
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Telephone | 719-632-6511
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 313M00000X
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Taxonomy Name | Nursing Facility/Intermediate Care Facility
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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 | 310400000X
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Taxonomy Name | Assisted Living Facility
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License Number |
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License Number State |
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