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NPI Code Detail

MEDICARE: CENTURA VENTURES, LLC

MEDICARE: CENTURA VENTURES, 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
1261QP2000XPhysical Therapy Clinic/Center

General Provider Information

NPI Number : 1528690195
Entity Type Code : Organization
Provider Name (Legal Business Name) : CENTURA VENTURES, LLC
Provider Business Mailing Address
First Line : PO BOX 801172
Second Line :
City : KANSAS CITY
State : MO
Zip : 64180-1172
Country : US
Telephone Number : 800-953-0104
Fax Number : 303-765-6670
Provider Business Practice Location Address
First Line : 4925 N NEVADA AVE
Second Line :
City : COLORADO SPRINGS
State : CO
Zip : 80918-8600
Country : US
Telephone Number : 719-776-4878
Fax Number : 719-776-4926
Authorized Official
Title or Position : VP, AMBULATORY SERVICES
Name : MS. DEBRA CARPENTER
Credential : RN
Telephone Number : 303-765-6998
Provider Enumeration Date : 02/11/2020
Last Update Date : 11/12/2024

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Directions to “CENTURA VENTURES, LLC ” Practice Location

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