Provider Demographics
NPI:1093705949
Name:HOSPICE OF THE PLAINS, INC.
Entity Type:Organization
Organization Name:HOSPICE OF THE PLAINS, INC.
Other - Org Name:HOSPICE OF THE PLAINS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO/ADMINISTRATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:TIFFANY
Authorized Official - Middle Name:A
Authorized Official - Last Name:STORCH
Authorized Official - Suffix:
Authorized Official - Credentials:RN, BSN, MSN
Authorized Official - Phone:970-526-7901
Mailing Address - Street 1:100 BROADWAY ST STE 1A
Mailing Address - Street 2:
Mailing Address - City:STERLING
Mailing Address - State:CO
Mailing Address - Zip Code:80751-2706
Mailing Address - Country:US
Mailing Address - Phone:970-526-7901
Mailing Address - Fax:970-526-7902
Practice Address - Street 1:302 N 9TH AVE
Practice Address - Street 2:
Practice Address - City:STERLING
Practice Address - State:CO
Practice Address - Zip Code:80751-2812
Practice Address - Country:US
Practice Address - Phone:970-526-7901
Practice Address - Fax:970-526-7902
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-10-24
Last Update Date:2024-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO0614251G00000X
315D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based
No315D00000XNursing & Custodial Care FacilitiesHospice, Inpatient
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO05800347Medicaid
CO0614OtherSTATE HOSPICE LICENSURE
CO05800347Medicaid