Provider Demographics
NPI:1639644016
Name:KATHERINE AND CHARLES HOVER GREEN HOUSE INC
Entity Type:Organization
Organization Name:KATHERINE AND CHARLES HOVER GREEN HOUSE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:RUTH
Authorized Official - Middle Name:
Authorized Official - Last Name:HORTON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:303-772-9292
Mailing Address - Street 1:1380 CHARLES DR
Mailing Address - Street 2:
Mailing Address - City:LONGMONT
Mailing Address - State:CO
Mailing Address - Zip Code:80503-2354
Mailing Address - Country:US
Mailing Address - Phone:303-772-9292
Mailing Address - Fax:303-651-7279
Practice Address - Street 1:1425 BELMONT DR
Practice Address - Street 2:
Practice Address - City:LONGMONT
Practice Address - State:CO
Practice Address - Zip Code:80503
Practice Address - Country:US
Practice Address - Phone:303-772-9292
Practice Address - Fax:303-651-7279
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-10-11
Last Update Date:2022-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility