Provider Demographics
NPI:1568864098
Name:BRIDGES COMMUNITY HOMECARE OF COLORADO SPRINGS, LLC
Entity Type:Organization
Organization Name:BRIDGES COMMUNITY HOMECARE OF COLORADO SPRINGS, LLC
Other - Org Name:ENVISION HEALTHCARE AT HOME
Other - Org Type:Doing Business As
Authorized Official - Title/Position:COO
Authorized Official - Prefix:
Authorized Official - First Name:SHERIE
Authorized Official - Middle Name:
Authorized Official - Last Name:STEWART
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:801-225-7971
Mailing Address - Street 1:1345 W 1600 N STE 202
Mailing Address - Street 2:
Mailing Address - City:OREM
Mailing Address - State:UT
Mailing Address - Zip Code:84057-2431
Mailing Address - Country:US
Mailing Address - Phone:719-596-5001
Mailing Address - Fax:
Practice Address - Street 1:7150 CAMPUS DR STE 330
Practice Address - Street 2:
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80920-3180
Practice Address - Country:US
Practice Address - Phone:719-596-5001
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-09-16
Last Update Date:2022-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO8901810251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO59180056Medicaid