Provider Demographics
NPI:1124370929
Name:CONTINUUM PEDIATRIC NURSING SERVICES, INC.
Entity Type:Organization
Organization Name:CONTINUUM PEDIATRIC NURSING SERVICES, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:JOSEPH
Authorized Official - Middle Name:
Authorized Official - Last Name:GREEN
Authorized Official - Suffix:JR
Authorized Official - Credentials:
Authorized Official - Phone:703-564-1653
Mailing Address - Street 1:5340 S QUEBEC ST
Mailing Address - Street 2:SUITE 255N
Mailing Address - City:GREENWOOD VILLAGE
Mailing Address - State:CO
Mailing Address - Zip Code:80111-1909
Mailing Address - Country:US
Mailing Address - Phone:303-997-7411
Mailing Address - Fax:866-495-2577
Practice Address - Street 1:5340 S QUEBEC ST
Practice Address - Street 2:SUITE 255N
Practice Address - City:GREENWOOD VILLAGE
Practice Address - State:CO
Practice Address - Zip Code:80111-1909
Practice Address - Country:US
Practice Address - Phone:303-997-7411
Practice Address - Fax:866-495-2577
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:CONTINUUM PEDIATRIC NURSING SERVICES, INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2012-10-04
Last Update Date:2012-12-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO04D512251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO45652341Medicaid