Provider Demographics
NPI:1689754046
Name:TOTAL LONGTERM CARE, INC.
Entity Type:Organization
Organization Name:TOTAL LONGTERM CARE, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/CEO
Authorized Official - Prefix:MS
Authorized Official - First Name:MAUREEN
Authorized Official - Middle Name:
Authorized Official - Last Name:HEWITT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:303-869-4664
Mailing Address - Street 1:8950 E LOWRY BLVD
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80230-7030
Mailing Address - Country:US
Mailing Address - Phone:303-869-4664
Mailing Address - Fax:
Practice Address - Street 1:8950 E LOWRY BLVD
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80230-7030
Practice Address - Country:US
Practice Address - Phone:303-869-4664
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:TOTAL COMMUNITY OPTIONS
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-10-17
Last Update Date:2016-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes302F00000XManaged Care OrganizationsExclusive Provider Organization
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO04000881Medicaid
COH0613Medicare ID - Type Unspecified