Provider Demographics
NPI:1689173114
Name:SOLANGE AT THE WOODLANDS
Entity Type:Organization
Organization Name:SOLANGE AT THE WOODLANDS
Other - Org Name:HOUSE CALL MEDICAL
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:CHRISTEL
Authorized Official - Middle Name:
Authorized Official - Last Name:AIME
Authorized Official - Suffix:
Authorized Official - Credentials:RN-BSN
Authorized Official - Phone:719-231-2152
Mailing Address - Street 1:1900 E PIKES PEAK AVE STE 3
Mailing Address - Street 2:
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80909-5862
Mailing Address - Country:US
Mailing Address - Phone:719-391-4444
Mailing Address - Fax:
Practice Address - Street 1:1605 WHITETAIL DR
Practice Address - Street 2:
Practice Address - City:CASTLE ROCK
Practice Address - State:CO
Practice Address - Zip Code:80104-2809
Practice Address - Country:US
Practice Address - Phone:303-736-2814
Practice Address - Fax:303-736-2097
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-02-11
Last Update Date:2018-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO23N220310400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility