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General NPI Number Information
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NPI Number | 1720988538
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Entity Type | Organization
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Legal Business Name | EAGLE VALLEY SENIOR CARE
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Dates
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Enumeration Date | 11/06/2026
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Last Update Date | 11/06/2026
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Provider Practice Location Address
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Address Line | 195 FREESTONE RD
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City | EAGLE
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State | CO
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Zip | 81631-5930
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Country | US
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Telephone | 970-989-2500
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 1653
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City | EDWARDS
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State | CO
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Zip | 81632-1653
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | BOARD CHAIR
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Name | DAN GODEC
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Credential |
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Telephone | 970-390-6630
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 314000000X
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Taxonomy Name | Skilled Nursing Facility
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License Number |
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License Number State |
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