Provider Demographics
NPI:1710675509
Name:FAMILY CARE COLORADO LLC
Entity Type:Organization
Organization Name:FAMILY CARE COLORADO LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF OPERATIONS
Authorized Official - Prefix:
Authorized Official - First Name:BRITTANY
Authorized Official - Middle Name:
Authorized Official - Last Name:KESLER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:303-912-9712
Mailing Address - Street 1:9025 GRANT ST STE 200
Mailing Address - Street 2:
Mailing Address - City:THORNTON
Mailing Address - State:CO
Mailing Address - Zip Code:80229-4347
Mailing Address - Country:US
Mailing Address - Phone:303-912-9712
Mailing Address - Fax:
Practice Address - Street 1:3910 S CAREFREE CIR STE B
Practice Address - Street 2:
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80917-3053
Practice Address - Country:US
Practice Address - Phone:719-457-6001
Practice Address - Fax:719-596-1673
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-04-28
Last Update Date:2023-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO1932249588OtherPROVIDER NPI NUMBER