Provider Demographics
NPI:1861508822
Name:CATHOLIC HEALTH INITIATIVES COLORADO
Entity Type:Organization
Organization Name:CATHOLIC HEALTH INITIATIVES COLORADO
Other - Org Name:VILLA PUEBLO TOWERS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CFO, SENIOR SERVICES
Authorized Official - Prefix:MRS
Authorized Official - First Name:NANCY
Authorized Official - Middle Name:
Authorized Official - Last Name:STOKES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:303-715-7013
Mailing Address - Street 1:2425 S COLORADO BLVD
Mailing Address - Street 2:SUITE 250
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80222-5946
Mailing Address - Country:US
Mailing Address - Phone:866-905-0165
Mailing Address - Fax:303-715-7010
Practice Address - Street 1:1111 BONFORTE BLVD
Practice Address - Street 2:
Practice Address - City:PUEBLO
Practice Address - State:CO
Practice Address - Zip Code:81001-1801
Practice Address - Country:US
Practice Address - Phone:719-253-3710
Practice Address - Fax:719-544-1354
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-22
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO0330314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO7100594OtherEVERCARE - SENIOR HMO
CO05650007Medicaid
CO05650007Medicaid