Provider Demographics
NPI:1073882197
Name:CENTURA VENTURES, LLC
Entity Type:Organization
Organization Name:CENTURA VENTURES, LLC
Other - Org Name:CENTURA PHYSICAL THERAPY AT SISTERS GROVE PAVILION
Other - Org Type:Other Name
Authorized Official - Title/Position:VP, AMBULATORY SERVICES
Authorized Official - Prefix:MS
Authorized Official - First Name:DEBRA
Authorized Official - Middle Name:
Authorized Official - Last Name:CARPENTER
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:303-765-6998
Mailing Address - Street 1:PO BOX 801172
Mailing Address - Street 2:
Mailing Address - City:KANSAS CITY
Mailing Address - State:MO
Mailing Address - Zip Code:64180-1172
Mailing Address - Country:US
Mailing Address - Phone:800-953-0104
Mailing Address - Fax:303-765-6670
Practice Address - Street 1:6011 E WOODMEN RD
Practice Address - Street 2:STE 100
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80923-2605
Practice Address - Country:US
Practice Address - Phone:719-571-8888
Practice Address - Fax:719-571-8889
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-12-19
Last Update Date:2022-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy