Provider Demographics
NPI:1083362404
Name:PARK POINT HEALTHCARE LLC
Entity Type:Organization
Organization Name:PARK POINT HEALTHCARE LLC
Other - Org Name:PASCO/SW HOME HEALTH
Other - Org Type:Doing Business As
Authorized Official - Title/Position:TREASURER
Authorized Official - Prefix:
Authorized Official - First Name:LEE
Authorized Official - Middle Name:
Authorized Official - Last Name:JOHNSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:208-401-1369
Mailing Address - Street 1:2208 E MAIN ST
Mailing Address - Street 2:
Mailing Address - City:CORTEZ
Mailing Address - State:CO
Mailing Address - Zip Code:81321-4222
Mailing Address - Country:US
Mailing Address - Phone:970-565-6833
Mailing Address - Fax:970-564-8057
Practice Address - Street 1:45 S WASHINGTON ST
Practice Address - Street 2:
Practice Address - City:CORTEZ
Practice Address - State:CO
Practice Address - Zip Code:81321-3737
Practice Address - Country:US
Practice Address - Phone:970-565-6833
Practice Address - Fax:970-564-8057
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-03-15
Last Update Date:2023-04-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes311Z00000XNursing & Custodial Care FacilitiesCustodial Care Facility
No253Z00000XAgenciesIn Home Supportive Care