Provider Demographics
NPI:1942478979
Name:VOANS SENIOR COMMUNITY CARE OF COLORADO, INC.
Entity Type:Organization
Organization Name:VOANS SENIOR COMMUNITY CARE OF COLORADO, INC.
Other - Org Name:VOANS PACE, INC.
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:ASSISTANT SECRETARY
Authorized Official - Prefix:
Authorized Official - First Name:NANCY
Authorized Official - Middle Name:
Authorized Official - Last Name:GAVIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:952-983-4249
Mailing Address - Street 1:2377 ROBINS WAY
Mailing Address - Street 2:
Mailing Address - City:MONTROSE
Mailing Address - State:CO
Mailing Address - Zip Code:81401-5901
Mailing Address - Country:US
Mailing Address - Phone:907-252-0522
Mailing Address - Fax:970-252-0166
Practice Address - Street 1:2377 ROBINS WAY
Practice Address - Street 2:
Practice Address - City:MONTROSE
Practice Address - State:CO
Practice Address - Zip Code:81401-5901
Practice Address - Country:US
Practice Address - Phone:907-252-0522
Practice Address - Fax:970-252-0166
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-02-12
Last Update Date:2021-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251T00000XAgenciesProgram of All-Inclusive Care for the Elderly (PACE) Provider Organization
Provider Identifiers
StateIdentifier IDID TypeIssuer
H2815Medicare UPIN