Provider Demographics
NPI:1821623133
Name:TOC, INC
Entity Type:Organization
Organization Name:TOC, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:TRACY
Authorized Official - Middle Name:LAVON
Authorized Official - Last Name:MARTINEZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:970-874-6115
Mailing Address - Street 1:108 W 2ND ST
Mailing Address - Street 2:
Mailing Address - City:DELTA
Mailing Address - State:CO
Mailing Address - Zip Code:81416-1802
Mailing Address - Country:US
Mailing Address - Phone:970-874-6115
Mailing Address - Fax:970-874-6979
Practice Address - Street 1:108 W 2ND ST
Practice Address - Street 2:
Practice Address - City:DELTA
Practice Address - State:CO
Practice Address - Zip Code:81416-1802
Practice Address - Country:US
Practice Address - Phone:970-874-6115
Practice Address - Fax:970-874-6979
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:TOC, INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2020-03-06
Last Update Date:2020-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes311Z00000XNursing & Custodial Care FacilitiesCustodial Care Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO9000118781Medicaid