Provider Demographics
NPI:1497973747
Name:PULSE FAMILY ACUTE CARE CENTER, PROF. LLC
Entity Type:Organization
Organization Name:PULSE FAMILY ACUTE CARE CENTER, PROF. LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:KENNETH
Authorized Official - Middle Name:SEYMOUR
Authorized Official - Last Name:RAPER
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:719-495-9994
Mailing Address - Street 1:7475 MCLAUGHLIN RD
Mailing Address - Street 2:
Mailing Address - City:PEYTON
Mailing Address - State:CO
Mailing Address - Zip Code:80831-4716
Mailing Address - Country:US
Mailing Address - Phone:719-495-9994
Mailing Address - Fax:719-495-9904
Practice Address - Street 1:7475 MCLAUGHLIN RD
Practice Address - Street 2:
Practice Address - City:PEYTON
Practice Address - State:CO
Practice Address - Zip Code:80831-4716
Practice Address - Country:US
Practice Address - Phone:719-495-9994
Practice Address - Fax:719-495-9904
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-23
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO33292174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty