MEDICARE: REHABILITATION AND VISITING NURSE ASSOCIATION, LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	251E00000X	Home Health Agency		CO

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1376545640
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	REHABILITATION AND VISITING NURSE ASSOCIATION, LLC

Provider Business Mailing Address
First Line	:	450 S 900 E STE 100
Second Line	:
City	:	SALT LAKE CITY
State	:	UT
Zip	:	84102-2983
Country	:	US
Telephone Number	:	801-485-6166
Fax Number	:	801-531-1949

Provider Business Practice Location Address
First Line	:	4850 HAHNS PEAK DR UNIT 100
Second Line	:
City	:	LOVELAND
State	:	CO
Zip	:	80538-6001
Country	:	US
Telephone Number	:	970-330-5655
Fax Number	:	970-305-8610

Authorized Official
Title or Position	:	MANAGING PARTNER
Name	:	KENNETH E NORRIS
Credential	:
Telephone Number	:	801-712-7522

Provider Enumeration Date	:	06/01/2005
Last Update Date	:	03/06/2023

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