Provider Demographics
NPI:1629387667
Name:BOULDER COMMUNITY HOSPITAL
Entity Type:Organization
Organization Name:BOULDER COMMUNITY HOSPITAL
Other - Org Name:MAPLETON CENTER FOR REHABILITATION
Other - Org Type:Other Name
Authorized Official - Title/Position:REHAB COORDINATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:CAROL
Authorized Official - Middle Name:
Authorized Official - Last Name:BROOKS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:303-441-0522
Mailing Address - Street 1:3740 IRIS AVE APT D
Mailing Address - Street 2:
Mailing Address - City:BOULDER
Mailing Address - State:CO
Mailing Address - Zip Code:80301-2018
Mailing Address - Country:US
Mailing Address - Phone:303-441-2138
Mailing Address - Fax:
Practice Address - Street 1:3740 IRIS AVE
Practice Address - Street 2:UNIT D
Practice Address - City:BOULDER
Practice Address - State:CO
Practice Address - Zip Code:80301
Practice Address - Country:US
Practice Address - Phone:303-441-2138
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-09-24
Last Update Date:2010-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO12118518283X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes283X00000XHospitalsRehabilitation Hospital