Provider Demographics
NPI:1497358469
Name:NORTHWEST COLORADO VISITING NURSE ASSOCIATION
Entity Type:Organization
Organization Name:NORTHWEST COLORADO VISITING NURSE ASSOCIATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CREDENTIALING SPECIALIST
Authorized Official - Prefix:
Authorized Official - First Name:LESLEE
Authorized Official - Middle Name:
Authorized Official - Last Name:HURST
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:970-871-7680
Mailing Address - Street 1:745 RUSSELL ST
Mailing Address - Street 2:
Mailing Address - City:CRAIG
Mailing Address - State:CO
Mailing Address - Zip Code:81625-2019
Mailing Address - Country:US
Mailing Address - Phone:970-824-8233
Mailing Address - Fax:
Practice Address - Street 1:483 YAMPA AVE
Practice Address - Street 2:
Practice Address - City:CRAIG
Practice Address - State:CO
Practice Address - Zip Code:81625-2609
Practice Address - Country:US
Practice Address - Phone:970-871-7629
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:NORTHWEST COLORADO VISITING NURSE ASSOCIATION
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2020-11-20
Last Update Date:2020-11-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based