Provider Demographics
NPI:1407065022
Name:PARRISH CARE CENTER
Entity Type:Organization
Organization Name:PARRISH CARE CENTER
Other - Org Name:PARRISH'S PERSONAL BOARDING CARE HOME INC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JOYCE
Authorized Official - Middle Name:MERVINE
Authorized Official - Last Name:MICHAL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:719-495-5903
Mailing Address - Street 1:12164 PINE VALLEY CIR
Mailing Address - Street 2:
Mailing Address - City:PEYTON
Mailing Address - State:CO
Mailing Address - Zip Code:80831-4005
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:600 W 10TH AVE
Practice Address - Street 2:
Practice Address - City:YUMA
Practice Address - State:CO
Practice Address - Zip Code:80759-3214
Practice Address - Country:US
Practice Address - Phone:970-848-8444
Practice Address - Fax:719-495-5903
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-21
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COAL-0287310400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO76707725Medicaid