Provider Demographics
NPI:1073626891
Name:CATHOLIC HEALTH INITIATIVES COLORADO
Entity Type:Organization
Organization Name:CATHOLIC HEALTH INITIATIVES COLORADO
Other - Org Name:VILLAS AT SUNNY ACRES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:VP, FINANCE - CENTURA HEALTH
Authorized Official - Prefix:MRS
Authorized Official - First Name:NANCY
Authorized Official - Middle Name:
Authorized Official - Last Name:STOKES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:303-804-8188
Mailing Address - Street 1:188 INVERNESS DR W
Mailing Address - Street 2:SUITE 500
Mailing Address - City:ENGLEWOOD
Mailing Address - State:CO
Mailing Address - Zip Code:80112-5205
Mailing Address - Country:US
Mailing Address - Phone:303-804-8188
Mailing Address - Fax:303-290-8159
Practice Address - Street 1:2501 E 104TH AVE
Practice Address - Street 2:
Practice Address - City:THORNTON
Practice Address - State:CO
Practice Address - Zip Code:80233-4401
Practice Address - Country:US
Practice Address - Phone:303-255-4102
Practice Address - Fax:303-255-4192
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-16
Last Update Date:2015-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO1107314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO7100599OtherOPTUM - MEDICARE ADVANTAGE PRODUCT
CO05656053Medicaid
CO065108Medicare UPIN