Provider Demographics
NPI:1588662332
Name:UNION PRINTERS HOME
Entity Type:Organization
Organization Name:UNION PRINTERS HOME
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:CONNIE
Authorized Official - Middle Name:J
Authorized Official - Last Name:MILLER
Authorized Official - Suffix:
Authorized Official - Credentials:NHA
Authorized Official - Phone:719-634-3711
Mailing Address - Street 1:101 S UNION BLVD
Mailing Address - Street 2:
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80910-3137
Mailing Address - Country:US
Mailing Address - Phone:719-634-3711
Mailing Address - Fax:719-475-2246
Practice Address - Street 1:101 S UNION BLVD
Practice Address - Street 2:
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80910-3137
Practice Address - Country:US
Practice Address - Phone:719-634-3711
Practice Address - Fax:719-475-2246
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-07-13
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COAL-0264310400000X
CO0094314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered310400000XNursing & Custodial Care FacilitiesAssisted Living Facility
Not Answered314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO05650817Medicaid
CO04181889Medicaid
CO04181889Medicaid