Provider Demographics
NPI:1871006619
Name:PEAK FAMILY CARE
Entity Type:Organization
Organization Name:PEAK FAMILY CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:DIANE
Authorized Official - Middle Name:
Authorized Official - Last Name:COONRADT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:719-888-9383
Mailing Address - Street 1:4299 BRUSHRIDGE DR
Mailing Address - Street 2:
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80918-6104
Mailing Address - Country:US
Mailing Address - Phone:719-888-9383
Mailing Address - Fax:
Practice Address - Street 1:4299 BRUSHRIDGE DR
Practice Address - Street 2:
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80918-6104
Practice Address - Country:US
Practice Address - Phone:719-888-9383
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-11-15
Last Update Date:2017-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes385H00000XRespite Care FacilityRespite Care
No376J00000XNursing Service Related ProvidersHomemakerGroup - Single Specialty