Provider Demographics
NPI:1003885716
Name:ENSIGHT SKILLS CENTER, INC.
Entity Type:Organization
Organization Name:ENSIGHT SKILLS CENTER, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:DENISE
Authorized Official - Middle Name:L
Authorized Official - Last Name:MOYER
Authorized Official - Suffix:
Authorized Official - Credentials:COTA
Authorized Official - Phone:970-407-9999
Mailing Address - Street 1:1101 OAKRIDGE DR UNIT C
Mailing Address - Street 2:
Mailing Address - City:FORT COLLINS
Mailing Address - State:CO
Mailing Address - Zip Code:80525-5536
Mailing Address - Country:US
Mailing Address - Phone:970-407-9999
Mailing Address - Fax:970-207-9844
Practice Address - Street 1:1101 OAKRIDGE DR UNIT C
Practice Address - Street 2:
Practice Address - City:FORT COLLINS
Practice Address - State:CO
Practice Address - Zip Code:80525-5536
Practice Address - Country:US
Practice Address - Phone:970-407-9999
Practice Address - Fax:970-207-9844
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-03-15
Last Update Date:2023-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152WL0500XEye and Vision Services ProvidersOptometristLow Vision RehabilitationGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO1260967OtherSTATE EMPLOYMENT ID
CO04119OtherNORIDIAN TRADING PARTNER
CO1260967OtherSTATE EMPLOYMENT ID