Provider Demographics
NPI:1164502761
Name:NORTHWEST COLORADO VISTING NURSE ASSOCIATION
Entity Type:Organization
Organization Name:NORTHWEST COLORADO VISTING NURSE ASSOCIATION
Other - Org Name:NORTHWEST COLORADO HEALTH
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:
Authorized Official - First Name:MATT
Authorized Official - Middle Name:
Authorized Official - Last Name:MORRILL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:970-871-7635
Mailing Address - Street 1:940 CENTRAL PARK DRIVE SUITE 101
Mailing Address - Street 2:
Mailing Address - City:STEAMBOAT SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80487-8853
Mailing Address - Country:US
Mailing Address - Phone:970-879-1632
Mailing Address - Fax:970-870-1326
Practice Address - Street 1:483 YAMPA AVE
Practice Address - Street 2:
Practice Address - City:CRAIG
Practice Address - State:CO
Practice Address - Zip Code:81625-2019
Practice Address - Country:US
Practice Address - Phone:970-871-7629
Practice Address - Fax:970-826-4164
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-17
Last Update Date:2022-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care
No313M00000XNursing & Custodial Care FacilitiesNursing Facility/Intermediate Care Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO46859314Medicaid