Provider Demographics
NPI:1033590567
Name:CHEYENNE COUNTY HOSPITAL DISTRICT
Entity Type:Organization
Organization Name:CHEYENNE COUNTY HOSPITAL DISTRICT
Other - Org Name:MANOR TENDER CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:M
Authorized Official - Middle Name:F
Authorized Official - Last Name:SNYDER
Authorized Official - Suffix:
Authorized Official - Credentials:BA, NHA
Authorized Official - Phone:719-767-5602
Mailing Address - Street 1:PO BOX 938
Mailing Address - Street 2:
Mailing Address - City:CHEYENNE WELLS
Mailing Address - State:CO
Mailing Address - Zip Code:80810-0938
Mailing Address - Country:US
Mailing Address - Phone:719-767-5602
Mailing Address - Fax:719-767-5999
Practice Address - Street 1:561 W 1ST ST N
Practice Address - Street 2:
Practice Address - City:CHEYENNE WELLS
Practice Address - State:CO
Practice Address - Zip Code:80810-9705
Practice Address - Country:US
Practice Address - Phone:719-767-5602
Practice Address - Fax:719-767-5999
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-06-10
Last Update Date:2015-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO04R708251E00000X
CO04H568253Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
No253Z00000XAgenciesIn Home Supportive Care