Provider Demographics
NPI:1013304369
Name:FALCON HEALTHCARE
Entity Type:Organization
Organization Name:FALCON HEALTHCARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO/PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:RODRIC
Authorized Official - Middle Name:
Authorized Official - Last Name:FALCON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:719-761-2554
Mailing Address - Street 1:8565 SOUTH POPLAR WAY
Mailing Address - Street 2:CARE OF ROD FALCON
Mailing Address - City:LITTLETON
Mailing Address - State:CO
Mailing Address - Zip Code:80130
Mailing Address - Country:US
Mailing Address - Phone:719-761-2554
Mailing Address - Fax:303-660-7918
Practice Address - Street 1:8565 SOUTH POPLAR WAY
Practice Address - Street 2:CARE OF ROD FALCON
Practice Address - City:LITTLETON
Practice Address - State:CO
Practice Address - Zip Code:80130
Practice Address - Country:US
Practice Address - Phone:719-761-2554
Practice Address - Fax:303-660-7918
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-04-23
Last Update Date:2015-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO0990268363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Single Specialty