Provider Demographics
NPI:1093409716
Name:ALERACARE OF COLORADO, LLC
Entity Type:Organization
Organization Name:ALERACARE OF COLORADO, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SENIOR MANAGED CARE SPECIALIST
Authorized Official - Prefix:
Authorized Official - First Name:SYLVIE
Authorized Official - Middle Name:
Authorized Official - Last Name:VOSOUGH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:480-716-5820
Mailing Address - Street 1:4045 E BELL RD STE 157
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85032-2240
Mailing Address - Country:US
Mailing Address - Phone:480-716-5820
Mailing Address - Fax:480-716-5820
Practice Address - Street 1:1303 FORTINO BLVD STE C
Practice Address - Street 2:
Practice Address - City:PUEBLO
Practice Address - State:CO
Practice Address - Zip Code:81008-2032
Practice Address - Country:US
Practice Address - Phone:480-716-5820
Practice Address - Fax:480-716-5820
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-06-06
Last Update Date:2023-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM1300XAmbulatory Health Care FacilitiesClinic/CenterMulti-Specialty