Provider Demographics
NPI:1003687625
Name:TIFFANY'S SPECIALIZED CARE
Entity Type:Organization
Organization Name:TIFFANY'S SPECIALIZED CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:TIFFANY
Authorized Official - Middle Name:
Authorized Official - Last Name:VAUGHN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:720-660-0674
Mailing Address - Street 1:4855 RUSTY NAIL PT UNIT 102
Mailing Address - Street 2:
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80916-4757
Mailing Address - Country:US
Mailing Address - Phone:720-660-0674
Mailing Address - Fax:
Practice Address - Street 1:4855 RUSTY NAIL PT UNIT 102
Practice Address - Street 2:
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80916-4757
Practice Address - Country:US
Practice Address - Phone:720-660-0674
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-01-11
Last Update Date:2024-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes385HR2050XRespite Care FacilityRespite CareRespite Care Camp