Provider Demographics
NPI:1518464676
Name:COTTONWOOD COMMUNITY ALTERNATIVES INC
Entity Type:Organization
Organization Name:COTTONWOOD COMMUNITY ALTERNATIVES INC
Other - Org Name:COTTONWOOD COMMUNITY ALT
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:
Authorized Official - First Name:SEANNA
Authorized Official - Middle Name:
Authorized Official - Last Name:HORTON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:303-761-6487
Mailing Address - Street 1:PO BOX 946
Mailing Address - Street 2:
Mailing Address - City:ENGLEWOOD
Mailing Address - State:CO
Mailing Address - Zip Code:80151-0946
Mailing Address - Country:US
Mailing Address - Phone:303-761-6487
Mailing Address - Fax:303-761-5986
Practice Address - Street 1:133 COUNTY ROAD 17
Practice Address - Street 2:SUITE D-2/A
Practice Address - City:ELIZABETH
Practice Address - State:CO
Practice Address - Zip Code:80107-0107
Practice Address - Country:US
Practice Address - Phone:303-761-6487
Practice Address - Fax:303-761-5986
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-04-06
Last Update Date:2018-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes385H00000XRespite Care FacilityRespite Care
No376J00000XNursing Service Related ProvidersHomemakerGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO=========OtherTAX ID