Provider Demographics
NPI:1639177801
Name:ANIMAS EQUITY, INC.
Entity Type:Organization
Organization Name:ANIMAS EQUITY, INC.
Other - Org Name:THE VALLEY INN
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MANAGEMENT
Authorized Official - Prefix:MS
Authorized Official - First Name:KELLI
Authorized Official - Middle Name:L
Authorized Official - Last Name:LIKES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:970-516-1404
Mailing Address - Street 1:211 E 3RD AVE
Mailing Address - Street 2:
Mailing Address - City:MANCOS
Mailing Address - State:CO
Mailing Address - Zip Code:81328-9079
Mailing Address - Country:US
Mailing Address - Phone:970-533-9031
Mailing Address - Fax:970-533-7297
Practice Address - Street 1:211 E 3RD AVE
Practice Address - Street 2:
Practice Address - City:MANCOS
Practice Address - State:CO
Practice Address - Zip Code:81328-9079
Practice Address - Country:US
Practice Address - Phone:970-533-9031
Practice Address - Fax:970-533-7297
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-07-12
Last Update Date:2015-10-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO0158314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO05651880Medicaid
CO05651880Medicaid