Provider Demographics
NPI:1689113425
Name:TRUSTCARE OPERATORCO
Entity Type:Organization
Organization Name:TRUSTCARE OPERATORCO
Other - Org Name:COLORADO SPRINGS SENIOR HOMES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:DOUG
Authorized Official - Middle Name:
Authorized Official - Last Name:BROWN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:719-373-0185
Mailing Address - Street 1:3102 N PROSPECT ST
Mailing Address - Street 2:
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80907-5563
Mailing Address - Country:US
Mailing Address - Phone:719-301-6699
Mailing Address - Fax:
Practice Address - Street 1:3102 N PROSPECT ST
Practice Address - Street 2:
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80907-5563
Practice Address - Country:US
Practice Address - Phone:719-301-6699
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-02-13
Last Update Date:2017-03-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO230518310400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO12129364Medicaid